Glimepiride: new preparation. Just another hypoglycaemic sulphonylurea agent

(1) Glimepiride is another addition to the list of available antidiabetic sulphonylureas. The file contains nothing new on the potential clinical value of this type of treatment in noninsulin-dependent diabetes. (2) The efficacy of glimepiride was judged on the basis of fasting blood glucose and the level of glycated haemoglobin, i.e. laboratory end points. The recommended dose regimen (1-6 mg/day in a single intake) is validated by an adequate number of placebo-controlled trials. (3) Glimepiride was compared with two other antidiabetic sulphonylureas in large trials, one versus gliclazide in 459 patients and two versus glibenclamide, one of which included more than 1,000 patients. These trials showed no difference in blood glucose control between glimepiride and the other two sulphonylureas after treatment periods of 6 months to 1 year. (4) The safety profile of glimepiride seems similar to that of gliclazide or glibenclamide, but more follow-up in normal conditions of use is required. As a result, better-known sulphonylureas should be used in preference. (5) The fact that glimepiride can be administered in a single daily intake is not an advantage, as other sulphonylureas can also be used in this way.