Comparative Efficacy of Lobeglitazone Versus Pioglitazone on Albuminuria in Patients with Type 2 Diabetes Mellitus

Kyung-Soo Kim, Sangmo Hong, Hong-Yup Ahn, Cheol-Young Park, Kyung-Soo Kim, Sangmo Hong, Hong-Yup Ahn, Cheol-Young Park

Abstract

Introduction: The aim of this analysis was to evaluate the efficacy of lobeglitazone on albuminuria at 24 weeks of follow-up in patients with type 2 diabetes mellitus (T2DM) compared with pioglitazone using data from a randomized, double-blinded phase III trial.

Methods: In the phase III trial, patients who were inadequately controlled with metformin received 0.5 mg of lobeglitazone or 15 mg of pioglitazone for 24 weeks. Post hoc, exploratory analysis was used to investigate mean changes from baseline in the urine albumin-creatinine ratio (UACR) between the lobeglitazone (N = 104) and pioglitazone (N = 101) treatment groups.

Results: After 24 weeks of treatment, UACR was slightly decreased in the lobeglitazone group (- 4.3 mg/g creatinine [Cr]) compared to baseline and slightly increased in the pioglitazone group (5.2 mg/g Cr), with no change in the estimated glomerular filtration rate in either group; this difference was not statistically significant (P = 0.476). The incidence of new-onset microalbuminuria (2.4%) and the progression of albuminuria by > 1 stage (2.9%) in the lobeglitazone group were lower than the respective values in the pioglitazone group (6.8 and 6.1%, respectively). Of the patients in the lobeglitazone group, 50% exhibited regression to normoalbuminuria, compared to 39.3% of the patients in the pioglitazone. In subjects in the lobeglitazone group with micro- and macroalbuminuria, UACR tended to be more decreased and HbA1c was more reduced compared to those with normoalbuminuria (P = 0.014).

Conclusion: Lobeglitazone had a tendency to improve albuminuria in patients with T2DM and had comparable effects on albuminuria as pioglitazone which has demonstrated beneficial effects.

Trial registration: ClinicalTrials.gov identifier, NCT01106131.

Keywords: Albuminuria; Diabetes mellitus, type 2; Pioglitazone; Thiazolidinediones.

Figures

Fig. 1
Fig. 1
Mean changes from baseline in the urine albumin-creatinine ratio (UACR) at end of the follow-up period (week 24). Cr Creatinine
Fig. 2
Fig. 2
Boxplot of mean changes in glycated hemoglobin (HbA1c) at end of the follow-up period (week 24) according to albuminuria categories (a) and estimated glomerular filtration rate (eGFR) (b)

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