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Clinical Trials Update
November 26, 2014

No Mortality Benefit Found From Intensive Glucose Control

JAMA. 2014;312(20):2083. doi:10.1001/jama.2014.15874

Tight glucose control for an average of 5 years in patients with type 2 diabetes did not reduce mortality or major macrovascular events, investigators found in a posttrial follow-up of the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial (Zoungas S et al. N Engl J Med. doi:10.1056/NEJMoa1407963 [published online October 9, 2014]).

The 8494 participants in the follow-up study—the ADVANCE-Observational Study (ADVANCE-ON)—did, however, continue to have lower rates of death from any cause and from cardiovascular causes as a result of the perindopril-indapamide blood pressure–lowering treatment they had received for an average of 4.5 years as participants in the ADVANCE trial. The mortality benefit was attenuated compared with the original trial period but still statistically significant; the hazard ratios were 0.91 (95% CI, 0.84-0.99; P = .03) for risk of death from any cause and 0.88 (95% CI, 0.77-0.99; P = .04) for death from cardiovascular causes.

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