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Pioglitazone reduces cardiovascular events in T2D patients with CVD history

06 Apr 2020

Use of pioglitazone is associated with a reduced risk of major adverse cardiovascular events (MACE) and is recommended in patients with or at high risk of type 2 diabetes (T2D), particularly those with a history of established cardiovascular disease (CVD), suggests a study.

In addition, there have been significant decreases observed in renal disease progression regardless of baseline renal function.

PubMed, Embase and the Cochrane Library were searched for randomized controlled trials (RCTs) comparing pioglitazone with any control. Cardiovascular outcomes were as follows: MACE (defined as the composite of nonfatal myocardial infarction, nonfatal stroke and cardiovascular death), hospitalization for heart failure and all-cause mortality. Renal outcomes included change in urinary albumin to creatinine ratio and 24-hour urinary protein excretion.

Twenty-six studies involving 19,645 participants met the eligibility criteria. Pioglitazone led to a decrease in MACE risk (risk ratio [RR], 0.8, 95 percent confidence interval [CI], 0.7–0.9) in patients with a history of established CVDs but not in those without (RR, 1.0, 95 percent CI, 0.7–1.3).

For individual components, pioglitazone reduced the risks of nonfatal myocardial infarction (RR, 0.8, 95 percent CI, 0.6–1.0) and nonfatal stroke (RR, 0.8, 95 percent CI, 0.7–0.9) in patients with a history of established CVDs. No treatment effect was seen on cardiovascular death (RR, 1.0, 95 percent CI, 0.7–1.2) regardless of the presence of established CVDs.

However, pioglitazone increased the risk of hospitalization for heart failure (RR, 1.3, 95 percent CI, 1.1–1.6) and showed no effect on all-cause mortality (RR, 1.0, 95 percent, 0.8–1.1). In addition, pioglitazone led to an 18.5-percent (weighted mean difference, 18.5 percent, 95 percent CI, 21.1–16.0) decrease in albuminuria, with benefits also seen in those with different renal function categories.

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Most Read Articles
29 Jul 2020
Adjunctive perampanel appears to be safe and effective for long-term treatment of patients with tonic‐clonic seizures, according to a posthoc analysis.
27 Apr 2020
Long-term use of brivaracetam as an adjunctive treatment is well tolerated and effective in patients with focal seizures or primary generalized seizures, as shown in a study.
01 Apr 2019
Perampanel is safe and effective for treating refractory focal seizures in both Asian and non‐Asian populations, a study has found.
Elvira Manzano, 20 Jun 2018
A higher proportion of patients with systemic lupus erythematosus (SLE) experienced improvements in joint and skin symptoms with baricitinib 4 mg once daily vs placebo in a phase II randomized, double-blind, global study.