The Pharmaceutical Journal
Vol 280 No 7497 p428
12 April 2008

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Study shows pioglitazone reduces atheroma volume

Two studies designed to show the effects of pioglitazone and rimonabant on the progression of atherosclerosis were published last week in JAMA, with the findings simultaneously reported at the annual congress of the American College of Cardiology in Chicago.

The first study revealed that pioglitazone reduces the progression of coronary atherosclerosis in patients with type 2 diabetes and coronary artery disease compared with glimepiride (JAMA 2008;299:1561).

In 360 patients, ultrasonography showed that the primary outcome measure — change in percent atheroma volume (PAV) — increased by 0.73 per cent (95 per cent confidence interval 0.33 to 1.12) with glimepiride over 18 months, but decreased by 0.16 per cent (CI –0.57 to 0.25) with pioglitazone (P=0.002).

By contrast, the second study failed to show an effect for rimonabant on change in PAV compared with placebo (ibid, p1547). The drug did have a favourable effect on a secondary endpoint, however, reducing normalised total atheroma volume over the 18-month study period by 2.2mm³ (CI –4.09 to –0.24) compared with an increase of 0.88mm³ (CI –1.03 to 2.79) for placebo.

Neither study revealed an effect on cardiovascular outcomes or mortality.