RSS-Feed abonnieren
DOI: 10.1055/s-0029-1241195
© Georg Thieme Verlag KG Stuttgart · New York
Long-term Safety and Tolerability of Colesevelam HCl in Subjects with Type 2 Diabetes
Publikationsverlauf
received 01.05.2009
accepted 09.09.2009
Publikationsdatum:
27. Oktober 2009 (online)

Abstract
The bile acid sequestrant, colesevelam hydrochloride, is approved for glycemic control in adults with type 2 diabetes. In three double-masked, placebo-controlled studies, colesevelam hydrochloride 3.75 g/day demonstrated its glycemic-lowering properties when added to existing metformin-, insulin-, or sulfonylurea-based therapy in adults with inadequately controlled type 2 diabetes. This was a 52-week open-label extension study conducted at 63 sites in the United States and one site in Mexico to further evaluate the safety and tolerability of colesevelam hydrochloride in subjects with type 2 diabetes. All subjects who completed the three double-masked, placebo-controlled studies were eligible to enroll in this open-label extension. In total, 509 subjects enrolled and received open-label colesevelam hydrochloride 3.75 g/day for 52 weeks. Safety and tolerability of colesevelam hydrochloride was evaluated by the incidence and severity of adverse events. In total, 360 subjects (70.7%) completed the extension. Of the safety population, 361 subjects (70.9%) experienced an adverse event, most (88.1%) being mild or moderate in severity. Fifty-six adverse events (11.0%) were drug-related; the most frequent drug-related adverse events were constipation and dyspepsia. Thirty-five subjects (6.9%) discontinued due to an adverse event. Fifty-four subjects (10.6%) experienced a serious adverse event; only one was considered drug-related (diverticulitis). Seventeen subjects (3.3%) experienced hypoglycemia; most episodes were mild or moderate in severity. Glycemic improvements with colesevelam hydrochloride were seen without change in weight over 52 weeks (0.2 kg mean reduction from baseline). Colesevelam hydrochloride was safe and well-tolerated as long-term therapy for patients with type 2 diabetes.
Key words
antidiabetes agent - bile acid sequestrant - glucose - glycemic control - lipids
References
- 1
Bays HE, Goldberg RB, Truitt KE, Jones MR.
Colesevelam hydrochloride therapy in patients with type 2 diabetes mellitus treated
with metformin: glucose and lipid effects.
Arch Intern Med.
2008;
168
1975-1983
MissingFormLabel
- 2
Fonseca VA, Rosenstock J, Wang AC, Truitt KE, Jones MR.
Colesevelam HCl improves glycemic control and reduces LDL cholesterol in patients
with inadequately controlled type 2 diabetes on sulfonylurea-based therapy.
Diabetes Care.
2008;
31
1479-1484
MissingFormLabel
- 3
Goldberg RB, Fonseca VA, Truitt KE, Jones MR.
Efficacy and safety of colesevelam in patients with type 2 diabetes mellitus and inadequate
glycemic control receiving insulin-based therapy.
Arch Intern Med.
2008;
168
1531-1540
MissingFormLabel
- 4
Bays HE, Cohen DE.
Rationale and design of a prospective clinical trial program to evaluate the glucose-lowering
effects of colesevelam HCl in patients with type 2 diabetes mellitus.
Curr Med Res Opin.
2007;
23
1673-1684
MissingFormLabel
- 5
Overview of 6 years’ therapy of type II diabetes: a progressive disease (UKPDS 16).
Diabetes.
1995;
44
1249-1258
MissingFormLabel
- 6
Wallace TM, Matthews DR.
Coefficient of failure: a methodology for examining longitudinal beta-cell function
in type 2 diabetes.
Diabet Med.
2002;
19
465-469
MissingFormLabel
- 7
Brunzell JD, Davidson M, Furberg CD, Goldberg RB, Howard BV, Stein JH, Witztum JL.
Lipoprotein management in patients with cardiometabolic risk: consensus statement
from the American Diabetes Association and the American College of Cardiology Foundation.
Diabetes Care.
2008;
31
811-822
MissingFormLabel
- 8
Kuipers F, Stroeve JH, Caron S, Staels B.
Bile acids, farnesoid X receptor, atherosclerosis and metabolic control.
Curr Opin Lipidol.
2007;
18
289-297
MissingFormLabel
- 9
The Lipid Research Clinics Coronary Primary Prevention Trial results II. The relationship
of reduction in incidence of coronary heart disease to cholesterol lowering.
JAMA.
1984;
251
365-374
MissingFormLabel
- 10
Goldfine AB.
Modulating LDL cholesterol and glucose in patients with type 2 diabetes mellitus:
targeting the bile acid pathway.
Curr Opin Cardiol.
2008;
23
502-511
MissingFormLabel
- 11
Mitro N, Mak PA, Vargas L, Godio C, Hampton E, Molteni V, Kreusch A, Saez E.
The nuclear receptor LXR is a glucose sensor.
Nature.
2007;
445
219-223
MissingFormLabel
- 12
Fu L, John LM, Adams SH, Yu XX, Tomlinson E, Renz M, Williams PM, Soriano R, Corpuz R, Moffat B, Vandlen R, Simmons L, Foster J, Stephan JP, Tsai SP, Stewart TA.
Fibroblast growth factor 19 increases metabolic rate and reverses dietary and leptin-deficient
diabetes.
Endocrinology.
2004;
145
2594-2603
MissingFormLabel
- 13
Katsuma S, Hirasawa A, Tsujimoto G.
Bile acids promote glucagon-like peptide-1 secretion through TGR5 in a murine enteroendocrine
cell line STC-1.
Biochem Biophys Res Commun.
2005;
329
386-390
MissingFormLabel
- 14
Suzuki T, Oba K, Igari Y, Matsumura N, Watanabe K, Futami-Suda S, Yasuoka H, Ouchi M, Suzuki K, Kigawa Y, Nakano H.
Colestimide lowers plasma glucose levels and increases plasma glucagon-like PEPTIDE-1
(7–36) levels in patients with type 2 diabetes mellitus complicated by hypercholesterolemia.
J Nippon Med Sch.
2007;
74
338-343
MissingFormLabel
Correspondence
A. B. GoldfineMD
Assistant Professor
Harvard Medical School
Assistant Director of Clinical Research
Joslin Diabetes Center One Joslin Place
Boston
MA 02115
USA
Telefon: +1/617/732 2643
Fax: +1/617/713 3403
eMail: allison.goldfine@joslin.harvard.edu