ADVANCE
Action in Diabetes and Vascular Disease
Paziente / Popolazione Intervento / Esposizione Confronto Esito
In 11,140 patients with T2DM at high CV risk, gliclazide-based intensive control to HbA1c ≤6.5 % reduced the composite of microvascular and macrovascular events versus standard care.
N
11.140
Disegno
RCT, median 5 yr
Esito
Composite microvascular + macrovascular
Rilevanza
2
RisultatoHR 0.90 (0.82–0.98; p=0.01) — driven by −21 % new/worsening nephropathy. No mortality increase, no macrovascular benefit.
ADVANCE Collaborative Group. N Engl J Med. 2008;358(24):2560-2572. 10.1056/NEJMoa0802987
Discussione e critica
Counterweight to ACCORD: intensive control with gliclazide was safe, modestly renoprotective and free of the ACCORD mortality signal.