Physicians' Academy for Cardiovascular Education

Thiazolidinedione and sulfonylureas have similar CV benefit for diabetics on top of metformin

Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial

Literature - Vaccaro O, Masulli M, Nicolucci A, et al. - Lancet Diab Endocrinol 2017

Main results


In a real world clinical setting, both sulfonylureas and pioglitazone have a similar effect as add-on therapies to metformin regarding the incidence of total CV events in diabetic patients. These findings suggest that in T2DM patients without CV diseases, pioglitazone or a sulfonylurea are suitable alternatives as add-on treatment to metformin, although the combination of metformin and pioglitazone was advantageous in terms of durability of glycemic control and frequency of hypoglycemia.


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Find this article online at Lancet Diabetes Endocrinol

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