Trial reportDiabetes, obesity & metabolism2025
Efficacy and safety of pioglitazone, empagliflozin and glimepiride as third-line agents in patients with type 2 diabetes inadequately controlled with metformin and DPP-4 inhibitors: A multicentre, phase 4 randomized controlled trial.
Trial report in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
11 authors.
Funding
Abstract
aimsTo assess the efficacy and safety of three triple-combination therapies in patients with type 2 diabetes (T2D) inadequately controlled on metformin and a dipeptidyl peptidase-4 (DPP-4) inhibitor. MATERIALS AND
methodsThis multicentre, prospective, randomised, open-label, parallel-group, phase 4 study included patients with T2D inadequately controlled on metformin (≥1000 mg) and a DPP-4 inhibitor. Participants were randomised to receive empagliflozin 10 mg/day (n = 61), pioglitazone 15 mg/day (n = 58) or glimepiride 2 mg/day (n = 57). The primary outcome was glycated haemoglobin (HbA1c) level change after 24 weeks of treatment.
resultsThe mean age, HbA1c level and diabetes duration of the patients were 58.5 ± 10.0 years, 7.8 ± 0.7% and 8.1 ± 5.6 years, respectively. HbA1c level decreased after treatment (-0.78 ± 0.09, empagliflozin; -0.89 ± 0.09, pioglitazone; and -0.93 ± 0.12 glimepiride). No significant differences were observed in HbA1c reduction among the three triple-combination therapies. The proportions of patients with HbA1c < 7.0% were similar across the three regimens (65.6%, empagliflozin; 56.9%, pioglitazone; and 63.2%, glimepiride). Significant weight loss was observed in the empagliflozin group (-1.73 ± 3.14 kg), whereas weight gain was observed in the pioglitazone and glimepiride groups (1.11 ± 3.97 kg and 1.11 ± 4.07 kg, respectively). The glimepiride group reported four hypoglycaemic episodes (6.56%), while none were reported in the other groups.
conclusionsThe addition of empagliflozin, pioglitazone, or glimepiride to metformin and DPP-4 inhibitors significantly improved glycaemic control in patients with T2D. The selection of a third agent should be individualized based on the patient characteristics.
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