Clinical trials with glimepiride.
Data from 21 placebo-controlled, active-controlled or noncomparative studies involving more than 6500 patients, more than 4220 of whom were treated with glimepiride, are reviewed. Glimepiride has a rapid onset of action and is effective at a single daily dose. It is equally effective as the other second-generation sulfonylureas at doses of 1-8 mg/day, with doses above 4 mg/day reserved for patients with initial HbA(1c) above 8%. Glimepiride (at doses yielding the same blood-lowering effect as glyburide and glipizide), has a safety profile somewhat superior to that of glyburide, glipizide and gliclazide at a lower mg/day dose. Glimepiride also has been shown to be safe and effective in combination with insulin. Finally, glimepiride has two pharmacologic properties which have theoretical advantages over the other currently available sulfonylureas, but which have not as yet been shown to be clinically significant: it does not activate the cardiovascular K(ATP) channel and it achieves equivalent metabolic control at lower insulin secretion levels than the other sulfonylureas.
Clark
C M
CM
Regenstrief Institute for Health Care, Richard L. Roudebush Veterans Affairs Medical Center and the Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
Helmy
A W
AW