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Effect of rimonabant on glycemic control in insulin-treated type 2 diabetes: the ARPEGGIO trial

Priscilla A Hollander1, Aslam Amod, León E Litwak

  • 1Baylor University Medical Center, Dallas, Texas, USA. priscilh@baylorhealth.edu

Diabetes Care
|December 17, 2009
PubMed

Insights

Rimonabant improved glycemic control and reduced insulin dosage in type 2 diabetes patients. However, it increased adverse events like hypoglycemia and mood changes.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Pharmacology

Background:

  • Type 2 diabetes is a growing global health concern.
  • Insulin therapy is common but can be associated with weight gain and suboptimal glycemic control.
  • Selective cannabinoid receptor type-1 antagonists represent a novel therapeutic approach.

Purpose of the Study:

  • To evaluate the efficacy and safety of rimonabant in type 2 diabetes patients on insulin.
  • To assess rimonabant's impact on glycemic control (HbA1c) and cardiometabolic risk factors.
  • To determine changes in insulin dosage requirements and need for rescue medication.

Main Methods:

  • A 48-week, double-blind, placebo-controlled, multicenter trial.
  • 368 patients with type 2 diabetes (HbA1c > or =7%) receiving insulin monotherapy were randomized.
  • Primary outcome: change in HbA1c from baseline to week 48. Secondary outcomes: changes in body weight, waist circumference, and lipid levels.

Main Results:

  • Rimonabant significantly reduced HbA1c compared to placebo (-0.89% vs. -0.24%, P < 0.0001).
  • Significant improvements in cardiometabolic risk factors were observed with rimonabant.
  • More patients on rimonabant achieved >10% reduction in daily insulin dose and required less rescue medication.

Conclusions:

  • Rimonabant effectively improved glycemic control in type 2 diabetes patients on insulin.
  • Rimonabant positively impacted cardiometabolic risk factors and reduced insulin requirements.
  • Increased incidence of adverse events including hypoglycemia, nausea, dizziness, anxiety, and depression necessitates careful consideration.

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