Glibenclamide-related excess in total and cardiovascular mortality risks: Data from large Ukrainian observational cohort study

Khalangot, Mykola; Тronko, М.D.; Kravchenko, Victor; Kovtun, Volodymir

doi:10.1016/j.diabres.2009.09.008

Cited by 51 publications

(40 citation statements)

References 18 publications

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“…A few epidemiological studies have evaluated total and CV mortality according to the type of sulphonylurea drug used, with contrasting results (15,25,26,27,28,29). Only one study, to the best of our knowledge, has examined the association between sulphonylurea types and cancer-related mortality; this study revealed a protective effect of gliclazide (30).…”

Section: Introductionmentioning

confidence: 94%

“…Opening these channels in the heart appeared to be cardioprotective, and this effect was blocked by sulphonylureas (36). Indeed, sulphonylureas with a greater selectivity for b-cell receptors, such as glimepiride and gliclazide, have been associated with a lower CV risk (25,37), whereas glibenclamide has been associated with an excess allcause and CV mortality (15,25,26,27). The adverse effects reported for glibenclamide include increased peripheral vascular tone, reduced diazoxide-induced vasodilatation, the inhibition of preconditioning, increased infarct size, the inhibition of the fibrinolytic system and increased QT interval dispersion (2,36,38).…”

Section: Glibenclamidementioning

confidence: 99%

“…Furthermore, not all studies evaluated glibenclamide separately from other sulphonylureas but considered 'second-generation' sulphonylureas (13), or 'old sulphonylureas' (35), or 'sulphonylureas' alone (7,8,9,10,11,14,20). The possibility that the sulphonylureas are not equal in terms of all-cause mortality risk or CV risk had already been raised (1,2,3,4,5,12,13,15,25,26,27,28,29). Sulphonylureas act on b cells by blocking ATPdependent potassium channels; sulphonylurea receptors and functional potassium ATP channels have been identified as ubiquitous (36).…”

Section: Glibenclamidementioning

confidence: 99%

See 2 more Smart Citations

Mortality outcomes of different sulphonylurea drugs: the results of a 14-year cohort study of type 2 diabetic patients

Castiglione

Ghigo

et al. 2013

European Journal of Endocrinology

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Objective: Available data about mortality of type 2 diabetic patients treated with different sulphonylureas are scarce and contradictory. Design: We evaluated the associations between all-cause and cause-specific mortality and treatments with different sulphonylureas in a retrospective cohort of type 2 diabetic patients from a diabetes clinic. Methods: All 1277 patients treated with sulphonylureas during 1996-1997 were enrolled: 159 patients were treated with tolbutamide, 977 glibenclamide and 141 gliclazide. The baseline data (centralised laboratory parameters, anthropometric data and presence of chronic complications) were abstracted from the clinical records. Information on vital status was collected from demographic files after 14-year follow-up. Adjusted hazard ratios (HR) were estimated with Cox (all-cause mortality) or Fine and Gray models (cause-specific mortality), including several potential confounders. Results: Five hundred and fifty-six patients died during the follow-up: 262 from cardiovascular causes, 158 from cancer and 136 from other causes. When compared with the glibenclamide users, the gliclazide and tolbutamide users showed a significantly lower cancer mortality (HRZ0.30; 95% CI 0.16-0.55, and HRZ0.48; 95% CI 0.29-0.79 respectively). These results were strongly confirmed in the 555 patients on sulphonylurea monotherapy. None of the patients who were treated with gliclazide monotherapy died from cancer during the follow-up, and the patients on tolbutamide treatment exhibited a lower cancer mortality than the glibenclamide users (HRZ0.40; 95% CI 0.22-0.71). Data did not change after stratification for the duration of sulphonylurea treatment from diabetes diagnosis to the study enrolment. Conclusions: Cancer mortality was markedly reduced in the patients on gliclazide and tolbutamide treatment. These results suggest additional benefits for these drugs beyond their blood glucoselowering effect and strongly advocate for further investigation.

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Section: Introductionmentioning

confidence: 94%

Section: Glibenclamidementioning

confidence: 99%

Section: Glibenclamidementioning

confidence: 99%

See 1 more Smart Citation

Mortality outcomes of different sulphonylurea drugs: the results of a 14-year cohort study of type 2 diabetic patients

Castiglione

Ghigo

et al. 2013

European Journal of Endocrinology

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“…Sulphonylureas appear to increase the cardiovascular problems by blocking ATP dependent potassium channels. Among sulphonylurea subclasses glibenclamide has been associated with the risk of cardiovascular all-cause mortality [23][24][25] and is also reported to be associated with an elevated cancer-related mortality in diabetic patients [26]. However, Sulphonylureas have shown potentials in improving outcome after an acute ischemic stroke [27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Cognitive Impairment in Type 2 Diabetic Patients Treated with Metformin in Comparison with those Taking Glibenclamide

M¹,

Siavash²,

Ki³

et al. 2014

JNSK

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“…Glibenclamid-, glimepirid-és gliclazid-monoterápia összevetésében hasonló eredményt hozott egy 64 188 T2DM-es személy hatéves követését feldolgozó obszervációs vizsgálat is. Gliclazidot kapók körében mind az össz-, mind a keringési eredetű halálozás esélyhánya-dosa alacsonyabb volt a másik két származékot kapóké-nál [48,50]. A kedvező eredmény lehetséges magyará-zatát az ischaemiás prekondicionálás megtartottságában, az előnyös érhatásokban (atherogenesis lassítása, endothelvédelem, vasodilatatio elősegítése, thrombocyta-ér-fal hatások csökkenése) és a nephropathia előnyös befolyásolásában látják [48].…”

Section: áBraunclassified

The use of gliclazide in the mirror of the individualized sulfonylurea therapy

Winkler

2014

Orvosi Hetilap

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A szulfanilureavegyületek közös vércukorcsökkentő hatásuk mellett számos tulajdonságukban különböznek egymás-tól. Korábbi adatok a második generációs származék, a gliclazid, csoporton belüli lehetséges előnyeiről számoltak be. Noha az ezzel kapcsolatos megfi gyelések száma folyamatosan nő, újabb antidiabetikumok megjelenése miatt ezek az adatok kikerültek az érdeklődés előteréből. A közlemény áttekinti a rendelkezésre álló újabb kísérletes (receptoriális hatások, jelátviteli tényező aktiválásának hiánya, antioxidáns tulajdonság, a béta-sejt differenciálódásában szerepet játszó tényezők feltételezett serkentése), valamint farmakogenomikai adatokat és összeveti azokat a hatóanyaggal kapcsolatos klinikai tapasztalatokkal (hypoglykaemiaelőfordulás, cardiovascularis kimeneteli mutatók alakulása). Az összevetés megerősíti a gliclazid egyedi előnyét, mivel nem gátolja az ischaemiás prekondicionálást, pancreasszelektív, továbbá, más szulfanilureaszármazékokhoz képest mérsékli az atherogenesist, valamint a béta-sejt-vesztést. Bár ez a molekula sem mentes a szulfanilureákat általában jellemző hátrányoktól (vércukorszinttől független inzulinszekretagóg hatás, béta-sejt-depléció), sajátosságai előnyt jelenthetnek a csoporton belüli választás során. Orv. Hetil., 2014, 155(14), 541-548. Kulcsszavak: szulfanilureareceptor, Epac2, antioxidáns hatás, farmakogenomika, hypoglykaemia, béta-sejt-vesztésThe use of gliclazide in the mirror of the individualized sulfonylurea therapy In addition to the common blood glucose lowering effect, sulfonylurea compounds are different in many aspects from each other. Based on earlier fi ndings the second generation gliclazide has special advantages within this group. Although the number of experimental and clinical observations on gliclazide is continuously increasing, these novel fi ndings are not in the focus anymore due to the appearance of new antidiabetics. The article overviews recent experimental (receptorial effect, the absence of Epac2 activation, antioxidant properties, possible incentive of factors participating in beta-cell differentiation) and pharmacogenomic data, and compares them with clinical observations obtained from gliclazide treatment (hypoglycaemias, parame ters of cardiovascular outcome). The data underline the advantages of gliclazide, the highly pancreas-selective nature, preservation of the ischemic precondition, favourable hemodynamic properties and potential reduction of the beta-cell loss as compared to other compounds of the group. However, gliclazide is not free from disadvantages characteristic to sulfonylureas in general (blood glucose independent insulin stimulation, beta-cell depletion). Comparing gliclazide with other derivatives of the group, the above data indicate individual benefi ts for the application when sulfonylurea compound is the drug of choice.Keywords: sulfonylurea receptor, Epac2, antioxidant behaviour, pharmacogenomics, hypoglycemia, beta-cell mass Winkler, G.[The use of gliclazide in the mirror of the individualized sulfonylurea therapy]. Orv....

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Glibenclamide-related excess in total and cardiovascular mortality risks: Data from large Ukrainian observational cohort study

Cited by 51 publications

References 18 publications

Mortality outcomes of different sulphonylurea drugs: the results of a 14-year cohort study of type 2 diabetic patients

Mortality outcomes of different sulphonylurea drugs: the results of a 14-year cohort study of type 2 diabetic patients

Cognitive Impairment in Type 2 Diabetic Patients Treated with Metformin in Comparison with those Taking Glibenclamide

The use of gliclazide in the mirror of the individualized sulfonylurea therapy

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