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Title : COMPARISONS OF EFFECTIVENESS, SAFETY, AND PHARMACOKINETIC PARAMETERS BETWEEN LOW AND HIGH DOSES OF PIOGLITAZONE IN TYPE 2 DIABETIC PATIENTS
Authors : *Wannakamol Sonsingh, Duangchit Panomvana and Wallaya Jongjaroenprasert
Abstract : Pioglitazone (PIO) is highly effective in decreasing blood glucose levels for type 2 diabetes mellitus (T2D), but it can induce serious adverse events such as edema and heart failure (HF). Some previous studies showed that the efficacy on glucose control and lipid levels was not related to the difference in doses of PIO in opposite to the incidence of edema which was doses-dependent of PIO. To compare glucose control, lipid control, adverse events, and pharmacokinetic (PK) parameters between low and high doses of PIO in T2D. Medical chart of 139 diabetic patients using PIO at Ramathibodi hospital were reviewed to compare outcomes and adverse effects between low and high doses of PIO. 38 patients who stabilized dose of PIO and agree to participate were recruited to collect 2 blood samples at 2 appropriated times and were analyzed their PIO concentrations, then, PK parameters were determined. The outcomes of glucose control and lipid control were not differences between low and high dose of PIO, but edema and HF events were significantly higher in high dose of PIO (P=0.010 and P=0.014, respectively). For PK parameters of PIO, elimination rate constant (ke) and clearance rate (CL) values of patients who were stabilized on high dose of PIO were significantly higher (P=0.022 and P=0.031, respectively) while elimination half-life (t1/2) was significantly shorter (P=0.007) than those who were stabilized on low dose of PIO. PK monitoring for optimal dose of PIO might possibly provide good controlling of blood glucose and lower adverse events in T2D. <br />

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