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ACTOS® (pioglitazone) reverses thickening of
carotid artery wall in type 2 diabetes
6/11/04 - 10/11/04, New Orleans, LA
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Scientific Sessions, the largest cardiovascular meeting
in the world, is being held in New Orleans Nov. 6–10.
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Mainz, Germany, November 9, 2004 – Clinical study
results presented today in New Orleans, Louisiana, during the
American Heart Association's Scientific Sessions 2004
proceedings, have shown that the drug pioglitazone (ACTOS®,
Takeda) significantly reduced the thickness of the carotid
(neck) artery in patients with type 2 diabetes.
By contrast, no change in carotid thickness was seen in a
group of patients who received glimepiride, an older drug for
type 2 diabetes.
"These results are provocative, because both drugs showed
similar effects on lowering blood glucose, the traditional
principal target for type 2 diabetes therapy," noted principal
investigator Thomas Forst, Professor for Internal Medicine,
Institute for Clinical Research and Development in Mainz,
Germany.
"The thickness of the carotid artery is an indicator of
atherosclerotic disease, which may both reduce arterial blood
flow and set the stage for unstable blood clots in the arteries
to dislodge and potentially cause a heart attack or stroke. The
reduction in thickness by pioglitazone, a member of a new class
of type 2 diabetes drugs called thiazolidinediones (TZDs)
suggests that this medication may have benefits beyond improving
metabolic control in patients with diabetes mellitus type 2,"
continued Forst. "This substantial regression of carotid intima
media thickness over just 12 or 24 weeks may have important
prognostic implications for patients with type 2 diabetes."
Study Design and Results
In the study, B-mode ultrasound was used to measure the
intima media thickness (IMT) of the carotid artery before and 12
and 24 weeks after 173 patients received oral therapy with
either pioglitazone (45 mg/day) or glimepiride (1-6 mg/day).
Baseline carotid IMT was 0.949 ± 0.149mm in the pioglitazone
group and 0.924 ± 0.150mm in the glimepiride group (p=n.s.).
Carotid IMT was reduced only in the pioglitazone group after 12
weeks (-0.033 ± 0.052mm) vs. -0.002 ± 0.047mm in the glimepiride-treated
patients (p = 0.0002 between groups) and after 24 weeks of
treatment (-0.054 ± 0.059mm vs. -0.011 ± 0.058mm, respectively,
p < 0.0001 between groups). In addition, insulin resistance was
significantly improved in the pioglitazone group (-2.21 ± 3.40
vs. -0.27 ± 3.30, p < 0.0001 between groups). Changes in IMT
correlated with improvement in insulin resistance (r=0.29,
p<0.001) and were independent from the improvement in metabolic
control.
The population included 66 females and 107 males with type 2
diabetes aged 62.6 +/- 1 7.9 years, with a mean body mass index
(BMI) of 31.8 (generally classified as obese). Both treatments
were generally well tolerated.
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American Heart Association - scientific sessions - 6/11/04 - 10/11/04, New Orleans, LA Legal Disclaimer
The materials presented here were prepared by independent authors
under the editorial supervision of The Doctors Lounge, and do not represent a
publication of the American Heart Association. These
materials and the related activity are not sanctioned by the American
Heart Association or the commercial supporter of the
conference, and do not constitute an official part of that conference.
The material presented here does not reflect the views of The Doctors
Lounge or
the companies providing unrestricted educational grants. These materials
may discuss uses and dosages for therapeutic products that have not been
approved by the United States Food and Drug Administration. A qualified
health care professional should be consulted before using any
therapeutic product discussed. All readers or continuing education
participants should verify all information and data before treating
patients or employing any therapies described in this educational
activity.
Copyright © 2004 The Doctors Lounge.
| Article reviewed by: |
Dr. Tamer Fouad, M.D.
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