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Glyburide, Gliclazide or Glimepiride for Elderly Patients with Type 2 Diabetes: An Updated Review of the Clinical Effectiveness and Safety

Last updated: August 20, 2015
Project Number: RC0693-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the comparative clinical effectiveness of glyburide versus gliclazide or glimepiride in elderly patients with type 2 diabetes?
  2. What is the clinical evidence regarding the safety of glyburide, gliclazide or glimepiride in elderly patients with type 2 diabetes?

Key Message

Limited evidence from four non-randomized studies suggests an increased risk of progression towards adverse renal endpoints with the use of glimepiride versus gliclazide, as well as conflicting results regarding the risk of progression to cardiovascular endpoints with the use of glyburide versus gliclazide in elderly patients. This indicates a need for further high quality prospective research on this topic. No recent evidence was identified regarding the comparative clinical effectiveness of second-generation sulfonylureas.