The Pharmaceutical Journal
Vol 277 No 7427 p599
18 November 2006

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Pioglitazone treatment shows promise for atherosclerosis in diabetes

People with type 2 diabetes treated with pioglitazone have slower progression of a particular marker for coronary atherosclerosis than those taking glimepiride, according to a study released online this week (JAMA, 13 November 2006).

Of 462 patients randomly assigned to treatment, 175 patients in the pioglitazone group and 186 in the glimepiride group were included in an analysis of carotid artery intima-media thickness (CIMT) — a marker for coronary atherosclerosis and independent predictor of cardiovascular events. Investigators found that, at 72 weeks, mean CIMT had progressed less in pioglitazone subjects than in glimepiride subjects (–0.001mm versus 0.012mm, difference –0.013mm, 95 per cent confidence interval –0.024 to –0.002; P=0.02). Progression of maximum CIMT was also slowed in the pioglitazone group compared with the glimepiride group (P=0.008).

However, the authors concede that the study “was not powered to detect a difference in cardiovascular endpoints and, therefore, does not establish that treatment with pioglitazone compared with glimepiride will reduce these end points in patients with type 2 diabetes mellitus”.