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Acb4.0
Acarbose – Forschung
Überwiegend Mechanismus / Beobachtung
28 begutachtete Studien
Was die Evidenz sagt
Überwiegend Mechanismus / Beobachtung
Die meisten Studien zu Acarbose sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.
Die meiste Evidenz stammt aus hochwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 2003–2026 mit einer typischen Studiengröße von 291 Teilnehmenden.
Basierend auf 28 Studien · 3 Meta-Analysen · 7 RCTs · 18,046 Teilnehmende insgesamt
Konfidenz
Hohe Konfidenz
Nach Outcome
Lifespan & aging (preclinical)
Überwiegend Mechanismus / Beobachtung9 Studien
Cardiovascular & glycemicVerringerte kardiovaskuläre Ereignisse und Fortschreiten zu Diabetes bei Personen mit gestörter Glukosetoleranz · Jahre
Überwiegend Mechanismus / Beobachtung9 Studien
Safety profile
Zu wenige bewertete Studien2 Studien
Aktives Forschungsgebiet
24 Studien in den letzten 5 Jahren · Neueste Meta-Analyse: 2025
200320142026
1Systematische Übersicht2026
Given its association with cardiovascular events and mortality, the improved recognition and management of PPH are critical in geriatric care.
Ishikawa J, Toba A, Futami S, Harada K. · Geriatrics & gerontology international (2026)
Emerging therapies involving gut peptides, such as GLP-1 analogs and DPP-4 inhibitors, show promise, especially in patients with α-synucleinopathies.
PPH frequently coexists with OH and supine hypertension, complicating diagnosis and treatment.
Screening for positional BP dysregulation and tailoring interventions for individual autonomic profiles are essential.
This review provides a strategic framework for developing safer, more selective antidiabetic agents through systematic exploitation of heterocyclic chemistry, advancing toward personalized diabetes management.
Emerging frontiers include multi-agonist therapies (GLP-1/GIP, dual SGLT1/SGLT2 inhibitors), glucokinase activators for insulin-independent glucose control, microbiome-targeting agents, and AI-driven rational drug design integrating SAR, docking, and ADMET prediction.
This review provides a strategic framework for developing safer, more selective antidiabetic agents through systematic exploitation of heterocyclic chemistry, advancing toward personalized diabetes management.
Notably, numerous derivatives demonstrate superior inhibition compared to the standard reference drug, acarbose.
Shafiee SM, Asadi M, Mahdavi M, Saeedi M. · Archiv der Pharmazie (2026)
Benzimidazole derivatives have emerged as important scaffolds in the development of potent and effective α-glucosidase inhibitors, key targets for managing type 2 diabetes mellitus (T2DM).
This review highlights structural innovations and structure-activity relationships (SARs) of diverse benzimidazole-based compounds, including hybrids with Schiff bases, thiosemicarbazones, 1,2,3-triazoles, and oxadiazoles, all exhibiting α-glucosidase inhibitory activity.
Notably, numerous derivatives demonstrate superior inhibition compared to the standard reference drug, acarbose.
Trial registration EU Clinical Trials Register: EudraCT-nr. 2022-003320-40.
Holmbäck U, Grudén S, Kuusk S, Litorp H, Englund J, Söderhäll A, Alderborn G, Forslund A. · Obesity (Silver Spring, Md.) (2025)
Results Mean relative weight loss was -7.73% for the EMP16 group as compared to -5.78% for the MR-O group and -5.13% for the Conv-O group (p < 0.01).
Proportion achieving ≥ 5% or ≥ 10% weight reduction was 61%/32% in EMP16 group, compared to 51%/20% in the MR-O and 48%/12% in the Conv-O group (p > 0.05 for ≥ 10%).
All groups showed small improvements in glucose and lipid markers, with EMP16 demonstrating greater improvement in fatty liver index and quality of life compared to Conv-O (p < 0.01).
However, caution should be exercised due to significant heterogeneity among the studies, and results may evolve with additional research.
Xiao Y, Zhao Z, Chen B, Sun J, Wang L, Wang Y, Nan Z, Zhang Q. · PeerJ (2025)
The results showed that emodin significantly reduced the glucose and lipid metabolism indicators and effectively lowered body weight and serum insulin levels (FBG, 2hPG(IPGTT/OGTT), IPITT, TG, TC, LDL-c, HDL-c) ( P < 0.05).
Additionally, emodin shares characteristics with first-line antidiabetic drugs such as metformin, acarbose, and repaglinide, promoting insulin secretion and enhancing cellular sensitivity to insulin.
Furthermore, emodin exhibits actions similar to glucagon-likepeptide-1(GLP-1) receptor agonists, suggesting its potential for protecting target organs.
Conclusions The combination of glimepiride/glibenclamide and rosiglitazone was the most effective hypoglycaemic regimen for protecting beta-cell function and improving glycaemic control in T2DM treatment, possibly due to control of HbA1c and glycotoxicity.
Guo Z, Huang L, Jiang Z, Bai X, Wang Z, Huang H. · European journal of medical research (2025)
Direct and indirect evidence types were combined to calculate weighted mean difference (WMD) and 95% confidence interval (CI) values for the change in (△) HOMA-β and △HbA1c, and to determine surface under the cumulative ranking curve (SUCRA) values.
The mean patient age was 66.70 years, and 54.14% were male.
For improving HOMA-β, the top treatments were glimepiride + rosiglitazone (WMD = 81.83, 95% CI 45.85-117.82) and glibenclamide + rosiglitazone (WMD = 79.51, 95% CI 40.66-118.36).
Trial registration Chinese Clinical Trial Registry: ChiCTR2000039424.
Cai X, Hu S, Lin C, Wu J, Wang J, Wang Z, Zhang X, Wang X, Xu F, Chen L, Yang W, Nie L, Ji L. · Chinese medical journal (2025)
We recruited patients with type 2 diabetes aged 18-65 years with body mass index (BMI) within 19-40 kg/m 2 and hemoglobin A1c (HbA1c) between 6.5% and 9.0%.
There was no statistically significant difference in TIR between the two groups.
Median (25th percentile, 75th percentile) of TBR below target level <3.9 mmol/L (TBR 3.9 ): Acarbose: 0.45% (0, 2.13%) vs .
The review paves the way for medicinal chemists to develop new 1,2,4-triazole-incorporating molecular entities to build safe and effective agents for diabetes treatment.
Abulkhair HS. · Future medicinal chemistry (2025)
A comparative analysis was conducted to identify the most effective methodology and the best starting material for the synthesis of this class.
Relative potencies and drug likeness characteristics of the reviewed candidates were also evaluated to identify whether one deserves forwarding to pre-clinical and clinical assessments.
Many of these derivatives exhibited potent α-glucosidase enzyme inhibition, often outperforming standard marketed drugs like Acarbose.
Clinical trial registry number ChiCTR-TRC-08000231.
Zhang C, Liu A, Teng W, Yang W, Li J, Shan Z. · Journal of endocrinological investigation (2025)
Results Eighty-four patients with subclinical hypothyroidism (SCH) exhibited a decrease in TSH levels (p = 0.001) with no significant differences between the two treatment groups (p = 0.460).
Both TFQI (p = 0.029) and PTFQI (p < 0.001) also decreased over time.
Mediation analysis revealed that these change over time were not mediated by BMI (all p < 0.05).
Conclusion Higher baseline glucagon significantly enhanced the glucose-lowering efficacy of acarbose but not metformin, suggesting glucagon could guide personalized diabetes treatment.
Jiang L, Zhou L, Liu J, Wang G. · Diabetes research and clinical practice (2025)
Results Significant reductions in HbA1c were observed in both acarbose and metformin groups at 24 and 48 weeks.
The primary outcome was changes in glycated hemoglobin A1c (HbA1c) at 24 and 48 weeks.
Conclusion Higher baseline glucagon significantly enhanced the glucose-lowering efficacy of acarbose but not metformin, suggesting glucagon could guide personalized diabetes treatment.
Results Hospitalizations were 6% higher in the acarbose arm during the trial (rate ratio 1.06, p = .009), but there were no significant differences in total inpatient days (rate ratio 1.04, p = .30).
Total costs per participant, including study drug, were significantly higher for acarbose (¥ [Yuan] 56 480, £6213), compared with placebo (¥48 079, £5289; mean ratio 1.18, p < 0.001).
Barinda AJ, Hardi H, Louisa M, Khatimah NG, Marliau RM, Felix I, Fadhillah MR, Jamal AK. · Frontiers in pharmacology (2024)
Aspirin and acarbose are the promising ones, whereas metformin exhibits various results.
In clinical trial registries, metformin, omega-3 fatty acid, acarbose, and atorvastatin are currently cardiometabolic drugs that are repurposed to target aging.
Published clinical trial results show great potential for omega-3 and metformin in healthspan.
Conclusions The notable effects of various dietary fibers when combined with different oral glucose-lowering medications should be considered to maximize therapeutic benefit.
Liu J, An Y, Yang N, Xu Y, Wang G. · Nutrition & diabetes (2024)
Higher intake of total fiber and whole grain fiber was positively associated with better β-cell function, insulin sensitivity and postprandial glycemic control under acarbose treatment.
Conclusions The notable effects of various dietary fibers when combined with different oral glucose-lowering medications should be considered to maximize therapeutic benefit.
Higher fasting blood glucose, fasting insulin, HOMA-β, IR, and lower Matsuda index were indicators of better hepatic IR improvement.
Cui R, Wei Y, Liu J, Wang G. · Diabetes research and clinical practice (2024)
Results Multiple linear regression showed that baseline HIRI was positively associated with the rising degree of Matsuda index and the falling range of fasting blood glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and HIRI.
Conclusions Patients with higher levels of hepatic IR obtained better curative effects from metformin in terms of glycemic control, insulin saving, insulin sensitivity enhancement, and IR improvement.
Higher fasting blood glucose, fasting insulin, HOMA-β, IR, and lower Matsuda index were indicators of better hepatic IR improvement.
Lv Q, Yang Y, Lv Y, Wu Q, Hou X, Li L, Ye X, Yang C, Wang S. · Frontiers in endocrinology (2024)
The results indicated that exenatide had the best efficacy in slowing down cIMT progress, and exenatide [MD=-0.13,95%CI (-0.25, -0.01)], alogliptin [MD=-0.08,95%CI (-0.13, -0.02)] and metformin [MD=-0.05, 95%CI (-0.09, -0.02)] are more effective than placebo.
Result After screening 8395 citations, 25 studies (6675 patients) were included.
Conclusion Long-term treatment of exenatide, alogliptin, and metformin may be more effective than other hypoglycemic drugs in slowing the progression of cIMT.
The primary outcome was the percentage of time below range during CGM (interstitial glucose below 3.9 mM/70 mg/dL).
When compared with placebo, neither canagliflozin nor acarbose reduced the percentage of time below range (primary outcome, time below 3.9 mmol/L, median (IQR): screening 2.6 (0.7-5.1)%, placebo 1.2 (0.5-2.4)%, acarbose 1.1 (0.8-1.7)% and canagliflozin 0.8 (0.5-3.4)%).
For both treatments, no severe adverse events were documented.
Consistent with previous studies, minimal systemic absorption of orlistat and acarbose was observed for MR-OA, confirming that no significant alteration of the original substances occurs when modifying their release.
Grudén S, Forslund A, Litorp H, Kuusk S, Alderborn G, Söderhäll A, Holmbäck U. · Clinical pharmacology in drug development (2025)
This study aims to compare the pharmacodynamic properties of the orlistat component of MR-OA (MR-O) with a conventional orlistat product, Xenical (Conv-O), analyzing the percentage of fecal fat excretion.
MR-O and Conv-O similarly increased fecal fat percentage from 3.8% to 13.5%, confirming pharmacodynamic equivalence.
In Part II, participants received MR-OA and then Conv-O, with blood samples collected for 12 hours to measure orlistat and acarbose levels.
Although acarbose attenuated the mean decrease in SBP during the meal test, it did not reduce the actual number of PPH events recorded in a general population of older adults.ClinicalTrials.gov ID NCT01914133.
Madden KM, Feldman B, Meneilly GS. · Canadian journal on aging = La revue canadienne du vieillissement (2025)
Although the average decrease in SBP during the meal test was significantly attenuated in the acarbose group (standardized β = 0.724 ± 0.286, p = 0.017), the acarbose group experienced significantly more PPH events (standardized β = 0.593 ± 0.279, p = 0.040).
Some have recommended the use of acarbose (an alpha-glucosidase inhibitor) as a potential therapy for PPH based exclusively on studies of older adults with diabetes.
Using a randomized placebo-controlled design, 43 older adults (23 women, 20 men, mean age 77.1 ± 0.9 years) were recruited from geriatric medicine outpatient clinics in an academic centre.