| Efficacy and harms of the hypoglycemic agent pramlintide in diabetes mellitus. | |
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MedLine Citation:
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PMID: 21060125 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: We conducted a study to examine the efficacy, effectiveness, and harms of pramlintide as adjunct therapy in adults and children with type 1 or type 2 diabetes. METHODS: We searched multiple bibliographic databases to January 2010, the US Food and Drug Administration Web site, and other sources to identify randomized controlled trials (RCTs) fulfilling inclusion criteria. Syntheses were qualitative because data were too heterogeneous for meta-analysis. RESULTS: Three published RCTs in type 1 diabetes and 4 in type 2 disease fulfilled inclusion criteria. All trials were conducted with adults, and none was longer than 52 weeks. In type 1 diabetes with intensive insulin therapy, pramlintide was as effective as placebo in lowering glycated hemoglobin (HbA(1c)) levels in one trial. Pramlintide was somewhat more effective than placebo in patients using conventional insulin therapy, with a between-group difference in HbA(1c) levels of 0.2% to 0.3% (2 studies). In patients with type 2 diabetes, pramlintide was more effective at reducing HbA(1c) levels than placebo when added to flexibly dosed glargine (without prandial insulin) and when added to fixed-dose insulin therapies, with or without oral hypoglycemic agents (between-group differences in HbA(1c) were approximately 0.4%). Weight loss was observed with pramlintide in both type 1 and type 2 diabetes, whereas placebo-treated patients tended to gain weight. Pramlintide-treated patients experienced more frequent nausea and severe hypoglycemia compared with patients treated with placebo. CONCLUSIONS: Pramlintide was somewhat more effective than placebo as adjunct therapy for improving HbA(1c) levels and weight in adults with type 1 diabetes on conventional insulin therapy, or type 2 diabetes and inadequate glycemic control with their current therapies, with between-group differences in HbA(1c) levels in the range of 0.2% to 0.4%. Further research is needed to determine pramlintide's durability of hypoglycemic effect, as well as effects on patient-reported outcomes, morbidity, mortality, and long-term harms. |
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Authors:
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Nancy J Lee; Susan L Norris; Sujata Thakurta |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Annals of family medicine Volume: 8 ISSN: 1544-1717 ISO Abbreviation: Ann Fam Med Publication Date: 2010 Nov-Dec |
Date Detail:
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Created Date: 2010-11-09 Completed Date: 2011-02-24 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 101167762 Medline TA: Ann Fam Med Country: United States |
Other Details:
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Languages: eng Pagination: 542-9 Citation Subset: IM |
Affiliation:
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Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR 97239, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Glucose Databases, Bibliographic Diabetes Mellitus, Type 1 / drug therapy* Diabetes Mellitus, Type 2 / drug therapy* Disease Progression Hemoglobin A, Glycosylated Humans Hypoglycemic Agents / adverse effects, therapeutic use* Insulin / analogs & derivatives, therapeutic use Islet Amyloid Polypeptide / adverse effects, therapeutic use* Qualitative Research |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/Islet Amyloid Polypeptide; 0/glargine; 11061-68-0/Insulin; 151126-32-8/pramlintide |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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