Gliclazide
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
Gliclazide: From Type 2 Diabetes Mellitus to Classic Stiff Person Syndrome
One-Sentence Summary
Gliclazide is a sulfonylurea originally used to treat type 2 diabetes mellitus. The TxGNN model predicts it may be effective for classic stiff person syndrome, but there are currently 0 clinical trials and 0 publications supporting this direction, so the prediction rests on the model alone.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Type 2 diabetes mellitus (from the knowledge graph; the Singapore licence records contain no indication text) |
| Predicted New Indication | Classic stiff person syndrome |
| TxGNN Prediction Score | 97.96% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 17 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. From general pharmacology, gliclazide is a sulfonylurea that blocks the K-ATP channels (SUR1/Kir6.2) of pancreatic beta cells, which stimulates insulin secretion. Its efficacy in type 2 diabetes is well established.
Stiff person syndrome is an autoimmune neurological disorder, usually linked to anti-GAD65 antibodies and impaired GABAergic inhibition. The only speculative connection is the shared GAD65 autoimmune background with type 1 diabetes. Gliclazide has no known GABAergic or immunomodulatory action relevant to this disease. The high score is therefore a network-based association only, not a pharmacological rationale.
The same signal appears for focal stiff limb syndrome (identical score, 97.96%), which is likely driven by shared knowledge-graph neighbours.
Other Predictions in This Set
| Rank | Predicted Disease | Score | Assessment |
|---|---|---|---|
| 3 | Thiamine-responsive dysfunction syndrome | 97.79% | Likely refers to thiamine-responsive megaloblastic anaemia, which includes diabetes. Any benefit would be symptomatic glycaemic control only; the disease is treated with thiamine and insulin. |
| 4 | Opsismodysplasia | 97.72% | Loose link via PI3K/insulin signalling (INPPL1/SHIP2). Gliclazide does not act on this pathway. |
| 5 | Pancreatic agenesis | 96.64% | Mechanistically unsuitable: gliclazide needs functioning beta cells. Insulin replacement is the standard of care. |
| 6–9 | Localized lipodystrophies (drug-induced, centrifugal, pressure-induced, idiopathic) | 95.9–96.4% | Likely reflect metabolic-disease proximity in the graph. Gliclazide has no known effect on adipose tissue. |
| 10 | Autoimmune oophoritis | 88.15% | Speculative immunomodulatory link, not established. |
All of these have L5 evidence and a Hold recommendation.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Singapore Market Information
Gliclazide holds 17 valid single-ingredient licences in Singapore, with no cancelled licences. Approved indication text is not recorded in the licence data. The main authorizations are:
| Authorization Number | Product Name | Dosage Form | Manufacturer |
|---|---|---|---|
| SIN04316P | DIAMICRON TABLET 80 mg | Tablet | Les Laboratoires Servier Industrie |
| SIN11761P | DIAMICRON MR TABLET 30 mg | Tablet | Les Laboratoires Servier Industrie |
| SIN13868P | DIAMICRON MR TABLET 60 mg | Film-coated extended-release tablet | Les Laboratoires Servier Industrie / Servier (Ireland) Industries / Kotra Pharma (M) |
| SIN13468P | APO-GLICLAZIDE TABLET 80 mg | Tablet | Apotex Inc. |
| SIN14258P | APO-GLICLAZIDE MR TABLET 30 mg | Extended-release tablet | Apotex Inc. |
All forms are oral tablets (standard, film-coated, extended-release).
Safety Considerations
Please refer to the package insert for safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction has no supporting clinical trials or literature (L5), and there is no plausible pharmacological link between gliclazide and stiff person syndrome. Gliclazide is widely marketed in Singapore, but only for diabetes, so market availability does not support this new use.
To proceed, the following is needed:
- Mechanism of action data to assess any link to GABAergic or autoimmune pathways
- Package insert warnings and contraindications from the HSA website
- Preclinical or case-level evidence of benefit in stiff person syndrome
- Review of the indirect predictions with a possible symptom-level rationale (e.g., thiamine-responsive megaloblastic anaemia), separately from disease-modifying claims
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.