Pioglitazone

The forgotten, cost-effective cardioprotective drug for type 2 diabetes

Ralph A Defronzo, Silvio Inzucchi, Muhammad A Abdul-ghani, Steven E. Nissen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Type 2 diabetes individuals are at high risk for macrovascular complications: myocardial infarction, stroke and cardiovascular mortality. Recent cardiovascular outcome trials have demonstrated that agents in two antidiabetic classes (SGLT2 inhibitors and GLP-1 receptor agonists) reduce major adverse cardiovascular events. However, there is strong evidence that an older and now generically available medication, the thiazolidinedione, pioglitazone, can retard the atherosclerotic process (PERISCOPE and Chicago) and reduce cardiovascular events in large randomized prospective cardiovascular outcome trials (IRIS and PROactive). Pioglitazone is a potent insulin sensitizer, preserves beta-cell function, causes durable reduction in HbA1c, corrects multiple components of metabolic syndrome and improves nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Adverse effects (weight gain, fluid retention, fractures) must be considered, but are diminished with lower doses and are arguably outweighed by these multiple benefits. With healthcare expenses attributable to diabetes increasing rapidly, this cost-effective drug requires reconsideration in the therapeutic armamentarium for the disease.

Original languageEnglish (US)
JournalDiabetes and Vascular Disease Research
DOIs
StatePublished - Jan 1 2019

Fingerprint

pioglitazone
Type 2 Diabetes Mellitus
Myocardial Infarction
Costs and Cost Analysis
Drug Costs
Hypoglycemic Agents
Pharmaceutical Preparations
Weight Gain
Insulin
Delivery of Health Care
Mortality
Non-alcoholic Fatty Liver Disease
Therapeutics

Keywords

  • cardiovascular disease
  • Pioglitazone
  • type 2 diabetes mellitus

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

Cite this

Pioglitazone : The forgotten, cost-effective cardioprotective drug for type 2 diabetes. / Defronzo, Ralph A; Inzucchi, Silvio; Abdul-ghani, Muhammad A; Nissen, Steven E.

In: Diabetes and Vascular Disease Research, 01.01.2019.

Research output: Contribution to journalArticle

@article{b76d808e36454b2e9deadb467035bf50,
title = "Pioglitazone: The forgotten, cost-effective cardioprotective drug for type 2 diabetes",
abstract = "Type 2 diabetes individuals are at high risk for macrovascular complications: myocardial infarction, stroke and cardiovascular mortality. Recent cardiovascular outcome trials have demonstrated that agents in two antidiabetic classes (SGLT2 inhibitors and GLP-1 receptor agonists) reduce major adverse cardiovascular events. However, there is strong evidence that an older and now generically available medication, the thiazolidinedione, pioglitazone, can retard the atherosclerotic process (PERISCOPE and Chicago) and reduce cardiovascular events in large randomized prospective cardiovascular outcome trials (IRIS and PROactive). Pioglitazone is a potent insulin sensitizer, preserves beta-cell function, causes durable reduction in HbA1c, corrects multiple components of metabolic syndrome and improves nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Adverse effects (weight gain, fluid retention, fractures) must be considered, but are diminished with lower doses and are arguably outweighed by these multiple benefits. With healthcare expenses attributable to diabetes increasing rapidly, this cost-effective drug requires reconsideration in the therapeutic armamentarium for the disease.",
keywords = "cardiovascular disease, Pioglitazone, type 2 diabetes mellitus",
author = "Defronzo, {Ralph A} and Silvio Inzucchi and Abdul-ghani, {Muhammad A} and Nissen, {Steven E.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1177/1479164118825376",
language = "English (US)",
journal = "Diabetes and Vascular Disease Research",
issn = "1479-1641",
publisher = "SAGE Publications Ltd",

}

TY - JOUR

T1 - Pioglitazone

T2 - The forgotten, cost-effective cardioprotective drug for type 2 diabetes

AU - Defronzo, Ralph A

AU - Inzucchi, Silvio

AU - Abdul-ghani, Muhammad A

AU - Nissen, Steven E.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Type 2 diabetes individuals are at high risk for macrovascular complications: myocardial infarction, stroke and cardiovascular mortality. Recent cardiovascular outcome trials have demonstrated that agents in two antidiabetic classes (SGLT2 inhibitors and GLP-1 receptor agonists) reduce major adverse cardiovascular events. However, there is strong evidence that an older and now generically available medication, the thiazolidinedione, pioglitazone, can retard the atherosclerotic process (PERISCOPE and Chicago) and reduce cardiovascular events in large randomized prospective cardiovascular outcome trials (IRIS and PROactive). Pioglitazone is a potent insulin sensitizer, preserves beta-cell function, causes durable reduction in HbA1c, corrects multiple components of metabolic syndrome and improves nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Adverse effects (weight gain, fluid retention, fractures) must be considered, but are diminished with lower doses and are arguably outweighed by these multiple benefits. With healthcare expenses attributable to diabetes increasing rapidly, this cost-effective drug requires reconsideration in the therapeutic armamentarium for the disease.

AB - Type 2 diabetes individuals are at high risk for macrovascular complications: myocardial infarction, stroke and cardiovascular mortality. Recent cardiovascular outcome trials have demonstrated that agents in two antidiabetic classes (SGLT2 inhibitors and GLP-1 receptor agonists) reduce major adverse cardiovascular events. However, there is strong evidence that an older and now generically available medication, the thiazolidinedione, pioglitazone, can retard the atherosclerotic process (PERISCOPE and Chicago) and reduce cardiovascular events in large randomized prospective cardiovascular outcome trials (IRIS and PROactive). Pioglitazone is a potent insulin sensitizer, preserves beta-cell function, causes durable reduction in HbA1c, corrects multiple components of metabolic syndrome and improves nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Adverse effects (weight gain, fluid retention, fractures) must be considered, but are diminished with lower doses and are arguably outweighed by these multiple benefits. With healthcare expenses attributable to diabetes increasing rapidly, this cost-effective drug requires reconsideration in the therapeutic armamentarium for the disease.

KW - cardiovascular disease

KW - Pioglitazone

KW - type 2 diabetes mellitus

UR - http://www.scopus.com/inward/record.url?scp=85061212611&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061212611&partnerID=8YFLogxK

U2 - 10.1177/1479164118825376

DO - 10.1177/1479164118825376

M3 - Article

JO - Diabetes and Vascular Disease Research

JF - Diabetes and Vascular Disease Research

SN - 1479-1641

ER -