Pioglitazone reduces urinary albumin excretion in renin−angiotensin system inhibitor-treated type 2 diabetic patients with hypertension and microalbuminuria: the APRIME study

Background The aim of his study was to compare the efficacy of pioglitazone with metformin on the reduction of albuminuria in type 2 diabetic patients with hypertension and microalbuminuria treated with renin–angiotensin system inhibitors (RAS-Is). Methods The open-label, randomized trial was performed in type 2 diabetic patients with hypertension and microalbuminuria. On the basis of the treatment with RAS-Is, 68 patients with microalbuminuria received either pioglitazone (15–30 mg/day; n = 32) or metformin (500–750 mg/day; n = 31) for 52 weeks. Urinary albumin-to-creatinine ratio (UACR) was measured every 12 weeks. Results After 52 weeks of treatment, the changes in the log-UACR from baseline were −8.3% in the pioglitazone group and +4.2% in the metformin group ( p = 0.01), with similar glycemic and blood pressure changes. Conclusion The combination of pioglitazone and RAS-Is showed therapeutic benefit in the reduction of urinary albumin excretion for type 2 diabetic patients with hypertension and microalbuminuria.