Long-term effects of pioglitazone on carotid atherosclerosis in Japanese patients with type 2 diabetes without a recent history of macrovascular morbidity.

Abstract

AIM:

No previous studies have evaluated the long-term anti-atherosclerotic effects of pioglitazone in Asian patients with type 2 diabetes. Therefore, the present study investigated the protective effects of pioglitazone on the progression of carotid intima-media thickness (IMT), an established surrogate marker of cardiovascular events in Japanese type 2 diabetic patients without a recent history of cardiovascular morbidity.

METHODS:

This 2.5-4-year, randomized, open-label, blinded endpoint study was conducted in 6 centers across Japan. Patients received pioglitazone with or without other oral glucose-lowering drugs (excluding another thiazolidinedione) (n=89) or oral glucose-lowering drugs, excluding thiazolidinediones (n=97). Treatment was adjusted to achieve HbA(1c) <6.5%. The primary endpoints of the study were the absolute changes from the baseline to final visit in max- and mean-IMT in the average of bilateral common carotid arteries.

RESULTS:

Pioglitazone induced carotid IMT regression compared to baseline measurements (from 1.060 ± 0.2368 to 0.992 ± 0.1921 mm; p=0.0042 in max-IMT and from 0.839 ± 0.1873 to 0.780 ± 0.1571 mm; p=0.0019 in mean-IMT). Although the between-group difference did not reach statistical significance, the regression of carotid IMT values was greater in the pioglitazone-treatment group than in the non-pioglitazone group, (max-IMT: -0.069 ± 0.2199 mm vs -0.031 ± 0.2327 mm, respectively; p=NS, mean-IMT: -0.058 ± 0.1718 mm vs -0.043 ± 0.1644 mm, respectively; p=NS).

CONCLUSIONS:

Pioglitazone induced and maintained the long-term regression of carotid IMT in Japanese type 2 diabetic patients. This suggests that pioglitazone may inhibit the progression of atherosclerosis in this patient group. Further studies are required to verify these findings.

• Authors: Yoshimitsu Yamasaki, Naoto Katakami, Shigetaka Furukado, Kazuo Kitagawa, Kazuyuki Nagatsuka, Atsunori Kashiwagi, Hiroyuki Daida, Ryuzo Kawamori, Kohei Kaku
• Journal: Journal of atherosclerosis and thrombosis (J Atheroscler Thromb) Vol. 17 Issue 11 Pg. 1132-40 (Nov 27 2010) ISSN: 1880-3873 [Electronic] Japan
• PMID: 20686324 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Hypoglycemic Agents
• Thiazolidinediones
• Pioglitazone

Topics

• Adult
• Aged
• Asian People
• Carotid Arteries (drug effects)
• Carotid Artery Diseases (drug therapy, pathology)
• Case-Control Studies
• Comorbidity
• Diabetes Complications (drug therapy)
• Diabetes Mellitus, Type 2 (drug therapy, pathology)
• Female
• Humans
• Hypoglycemic Agents (therapeutic use)
• Male
• Middle Aged
• Pioglitazone
• Prognosis
• Prospective Studies
• Thiazolidinediones (therapeutic use)
• Time Factors
• Tunica Intima (drug effects)
• Tunica Media (drug effects)