ADVANCE

ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation) was a large-scale study, 2 x 2 factorial, randomized controlled trial. This study was designed to determine the effects of intensive treatment defined as the use of gliclazide (modified release) plus other drugs as required to achieve a glycated haemoglobin value of 6.5% or less, and routine blood pressure lowering treatment (ACE inhibitor plus diuretic) on cardiovascular outcomes. Medpharmgene was in charge of the coordination of the Canadian arm of the ADVANCE study.

Observations and analyses made during the study supported the following statements: 1) Administering the antihypertensive medication during the trial had significantly decreased the risk of micro and macro vascular complications as well as the death rate. (Lancet 2007;370). 2) Intensive glucose control also contributed to a decrease in the risk of vascular complications, primarily as a consequence of a 21% relative reduction in nephropathy. (New England Journal of Medicine 2008;358).

The joint analysis of the impact of blood pressure and glucose control demonstrated decrease of total mortality of 18%, cardiovascular mortality of 24% and that of renal impairment of 33% (Diabetes Care 2009;32).

Several scientific publications followed, including key articles providing novel clinically useful information. Taken together with other results yet to be published, the above results will allow establishment of better guidelines for use of the medication under study in ADVANCE and improvement the treatment regiments available for management of diabetes





The 4th ADVANCE regional meeting, Banff, Alberta, Canada, May 21-22, 2004

We are thankful to all Canadian investigators and coordinators for their contribution to ADVANCE trial:

Calgary Metabolic Education and Research Centre : S. Jetha, S. Ross, L. Visvanatha
Centre de recherche clinique de Laval : A. Bélanger, R. Dumas, S. Gauthier, M. Labbé, J. Raymond
Centre de recherche d’endocrinologie, Sherbrooke : C. Godin, C. Lachance, B. St-Pierre
Centre Hospitalier de l’Université de Sherbrooke : M-F. Langlois, P. Maheux, F. Poulin, C-L. Thibodeau
Centre hospitalier de l’Université de Montréal : J-L. Chiasson, N. Ciuria, F. Gossard, P. Hamet, L. Julien, S. Potvin, P. V. Nguyen, I. Vigneault
Centre Hospitalier Le Gardeur, Repentigny : J. Blais, G. Gosselin, N. Harvey, C. Masson, Y. Robitaille, C. Savard
Centre Hospitalier Régional de Lanaudière, Joliette : C. Durand, C. Fleury, S. Kouz, M. Proulx, M. Roy
Neureka Research, Timmins : J. Bradley, M. Marcoux, M. Parmar, T. Séguin
Centre hospitalier universitaire de Laval : M. Blanchet, F. Dubé, D. Garceau, C. Garceau, L. Kelly, I. Kirouac, L. Mercier, M. Pleau, E. Plourde, K. Raby, D. Trudel
Queen Elizabeth II Health Science Centre, Halifax : B. Al-Beiruti, C. Ingraham, A. McGibbon, A. Patterson, S. Reidy, J. Tuttle, E. Ur
St. Joseph’s Health Centre, London : L. Cauchi, N. Furtado, R. McManus, N. Rodger
Sudbury Cardiac Research : M. Ali, C. Dion, L. Forestell, K. Godden, S. McJannet, S. Nawaz, R. Poirier
University of British Colombia, Vancouver : K. Dawson, J. Lewis, D. Thompson
University of Toronto : D. Bédard, R. Josse, L. Leiter



The george institute - advance-trial


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