Acarbose for glucose intolerance lowers CV risk. (In Addition to Diabetes Prevention).

BERLIN -- Acarbose markedly reduces the risk of developing hypertension or having a cardiovascular event in patients with impaired glucose tolerance, in addition to protecting them against development of type 2 diabetes, Dr. Jean-Louis Chiasson reported at the 24th Congress of the European Society of Cardiology.

He presented a new secondary analysis of data from the Study to Prevent Noninsulin-Dependent Diabetes Mellitus (STOP-NIDDM) trial. In this multinational double-blind randomized controlled trial funded by Bayer AG, 1,429 patients with impaired glucose tolerance (IGT) were placed on 100 mg of acarbose three times per day or placebo and were followed for a mean of 3.3 years.

The primary study end point--development of type 2 diabetes--was recently published. Of patients treated with acarbose, 32% developed diabetes, compared with 42% of those on placebo--a statistically significant 25% reduction in risk (Lancet 359[9323]:2072-77, 2002).

But this figure from an intent-to-treat analysis underestimates the efficacy of acarbose in patients who stay on the drug. The analysis is diluted by inclusion of the 31% of patients in the acarbose group and 19% on placebo who discontinued treatment prematurely. So nearly one-third of patients classified as being on acarbose weren't actually on the drug for most of the study, explained Dr. Chiasson, professor of medicine at the University of Montreal.

He presented a secondary analysis of cardiovascular end points. Acarbose-treated patients were 34% less likely than those in the placebo arm to become hypertensive and 49% less likely to develop any cardiovascular event. Particularly impressive was the 91% reduction ...