Pioglitazone in type 2 diabetes therapy – updated data on efficacy and safety Review article
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Published:
Mar 31, 2012
Keywords:
type 2 diabetes, pioglitazone, oral antidiabetic agents
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Abstract
Number of people with type 2 diabetes is alarmingly growing worldwide. The disease develops in insulin resistant subjects in whom beta cell function fails to compensate ineffective insulin action. Pioglitazone belongs to thiazolidinedions group, and these drugs were invented primarily to improve insulin sensitivity. It is effective in monotherapy and in combination with other antidiabetic medications. The best results are seen when pioglitazone is combined with metformin and when used in obese individuals. Hypoglycemia risk associated with pioglitazone is very low, the drug has beneficial effect on lipid profile and does not increase cardiovascular risk. The main side effects include weight increase, fluid retention, increased risk of congestive heart failure and long bone fractures, especially in women. Currently available data indicate that benefits associated with pioglitazone use outweigh the risk of this therapy.
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Pawłowski, M., & Czupryniak, L. (2012). Pioglitazone in type 2 diabetes therapy – updated data on efficacy and safety. Medycyna Faktow (J EBM), 5(1(14), 10-15. Retrieved from https://journalsmededu.pl/index.php/jebm/article/view/2473
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References
1. Wild S., Roglic G., Green A. et al.: Global Prevalence of Diabetes Estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27: 1047-1053.
2. Wittek A., Sokalski B., Grzeszczak W. et al.: Prevalence of Diabetes and Cardiovascular Risk Factors of Industrial Area in Southern Poland. Exp. Clin. Endocrinol. Diabetes 2009; 117: 350-353.
3. De Fronzo R.A.: From the Triumvirate to the Ominous Octet: A New Paradigm for the Treatment of Type 2 Diabetes. Mellitus Diabetes 2009; 58: 773-795.
4. Sieradzki J.: Cukrzyca. Via Medica 2006.
5. Moczulski D.: Diabetologia. Medical Tribune 2010.
6. Questions and answers on the suspension of rosiglitazone-containing medicines [online].
7. Yki-Järvinen H.: Thiazolidinediones. N. Engl. J. Med. 2004; 351(11): 1106-18.
8. Hallakou S., Doare L., Foufelle F. et al.: Pioglitazone induces in vivo adipocyte differentiation in the obese Zucker fa/fa rat. Diabetes 1997; 46: 1393-9.
9. Eckland D.A., Danhof M.: Clinical pharmacokinetics of pioglitazone. Exp. Clin. Endocrinol. Diabetes 2000; 108(supl. 2): S234-242.
10. Miyazaki Y., Matsuda M., DeFronzo R.A.: Dose-Response Effect of Pioglitazone on Insulin Sensitivity and Insulin Secretion in Type 2 Diabetes Diabetes Care 2002; 25: 517-523.
11. Wallace T.M., Levy J.C., Matthews D.R.: An increase in insulin sensitivity and basal β-cell function in diabetic subjects treated with pioglitazone in a placebo-controlled randomized study. Diabet. Med. 2004; 21: 568-76.
12. Aronoff S., Rosenblatt S., Braithwaite S. et al.: Pioglitazone Hydrochloride Monotherapy Improves Glycemic Control in the Treatment of Patients With Type 2 Diabetes. Diabetes Care 2000; 23: 1605-1611.
13. Göke B.: Improved glycemic control and lipid profile in a randomized study of pioglitazone compared with acarbose in patients with type 2 diabetes mellitus. Treat. Endocrinol. 2002; 1(5): 329-36.
14. Pavo I., Jermendy G., Varkonyi T.T. et al.: Effect of pioglitazone compared with metformin on glycemic control and indicators of insulin sensitivity in recently diagnosed patients with type 2 diabetes. J. Clin. Endocrinol. Metab. 2003; 88(4): 1637-45.
15. Charbonnel B.H., Matthews D.R., Schernthaner G. et al.: A long term comparison of pioglitazone and gliclazide in patients with type 2 diabetes mellitus: a randomized, double-blind, parallel- group comparison trial. Diabet. Med. 2005; 22(4): 399-405.
16. Pfützner A., Marx N., Lübben G. et al.: Improvement of cardiovascular risk markers by pioglitazone is independent from glycemic control: results from the Pioneer study. J. Am. Coll. Cardiol. 2005; 45(12): 1925-31.
17. Einhorn D., Rendell M., Rosenzweig J. et al.: Pioglitazone hydrochloride in combination with metformin in the treatment of type 2 diabetes mellitus: a randomized, placebo-controlled study. The Pioglitazone 027 Study Group. Clin. Ther. 2000; 22(12): 1395-409.
18. Kipnes M.S., Krosnick A., Rendell M.S. et al.: Pioglitazone hydrochloride in combination with sulfonylurea therapy improves glycemic control in patients with type 2 diabetes mellitus: a randomized, placebo-controlled study. Am. J. Med. 2001; 111(1): 10-7.
19. Mattoo V., Eckland D., Widel M. et al.: Metabolic effects of pioglitazone in combination with insulin in patients with type 2diabetes mellitus whose disease is not adequately controlled with insulin therapy: results of a six-month, randomized, double-blind, prospective, multicenter, parallel-group study. Clin. Ther. 2005; 27: 554-67.
20. Goldberg R.B., Kendall D.M., Deeg M.A. et al.: A Comparison of Lipid and Glycemic Effects of Pioglitazone and Rosiglitazone in Patients With Type 2 Diabetes and Dyslipidemia. Diabetes Care 2005; 28: 1547-1554.
21. Promrat K., Lutchman G., Uwaifo G.I. et al.: A Pilot Study of Pioglitazone Treatment for Nonalcoholic Steatohepatitis. Hepatology 2004; 39: 188-196.
22. Yki-Järvinen H.: Thiazolidinediones and the liver in humans. Curr. Opin. Lipidol. 2009; 20(6): 477-83.
23. Naoumova P.R., Kindler H., Leccisotti L.: Pioglitazone Improves Myocardial Blood Flow and Glucose Utilization in Nondiabetic Patients With Combined Hyperlipidemia. JACC 2007; 50: 2051-8.
24. Derosa G.: Efficacy and Tolerability of Pioglitazone in Patients with Type 2 Diabetes Mellitus Comparison with Other Oral Antihyperglycaemic Agents. Drugs 2010; 70(15): 1945-1961.
25. Erdmann E., Spanheimer R., Charbonnel B.: Pioglitazone and the risk of cardiovascular events in patients with Type 2 diabetes receiving concomitant treatment with nitrates, renin–angiotensin system blockers, or insulin: results from the PROactive study (PROactive 20). Journal of Diabetes 2010; 2(3); 212-220.
26. Lincoff A.M., Wolski K., Nicholls S.J. et al.: Pioglitazone and Risk of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus A Meta-analysis of Randomized Trials JAMA. 2007; 298(10): 1180-1188.
27. Lewis J.D., Ferrara A., Peng T. et al.: Risk of Bladder Cancer Among Diabetic Patients Treated With Pioglitazone. Diabetes Care 2011; 34: 916-922.
28. Stanowisko FDA w sprawie ryzyka raka pęcherza moczowego związanego ze stosowaniem pioglitazonu [online].
29. Opinia EMA w sprawie stosowania pioglitazonu i związanym z tym ryzykiem raka pęcherza moczowego [online].
30. Nathan D.M., Buse J.B., Davidson M.B. et al.: Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2009; 32: 193-203.
2. Wittek A., Sokalski B., Grzeszczak W. et al.: Prevalence of Diabetes and Cardiovascular Risk Factors of Industrial Area in Southern Poland. Exp. Clin. Endocrinol. Diabetes 2009; 117: 350-353.
3. De Fronzo R.A.: From the Triumvirate to the Ominous Octet: A New Paradigm for the Treatment of Type 2 Diabetes. Mellitus Diabetes 2009; 58: 773-795.
4. Sieradzki J.: Cukrzyca. Via Medica 2006.
5. Moczulski D.: Diabetologia. Medical Tribune 2010.
6. Questions and answers on the suspension of rosiglitazone-containing medicines [online].
7. Yki-Järvinen H.: Thiazolidinediones. N. Engl. J. Med. 2004; 351(11): 1106-18.
8. Hallakou S., Doare L., Foufelle F. et al.: Pioglitazone induces in vivo adipocyte differentiation in the obese Zucker fa/fa rat. Diabetes 1997; 46: 1393-9.
9. Eckland D.A., Danhof M.: Clinical pharmacokinetics of pioglitazone. Exp. Clin. Endocrinol. Diabetes 2000; 108(supl. 2): S234-242.
10. Miyazaki Y., Matsuda M., DeFronzo R.A.: Dose-Response Effect of Pioglitazone on Insulin Sensitivity and Insulin Secretion in Type 2 Diabetes Diabetes Care 2002; 25: 517-523.
11. Wallace T.M., Levy J.C., Matthews D.R.: An increase in insulin sensitivity and basal β-cell function in diabetic subjects treated with pioglitazone in a placebo-controlled randomized study. Diabet. Med. 2004; 21: 568-76.
12. Aronoff S., Rosenblatt S., Braithwaite S. et al.: Pioglitazone Hydrochloride Monotherapy Improves Glycemic Control in the Treatment of Patients With Type 2 Diabetes. Diabetes Care 2000; 23: 1605-1611.
13. Göke B.: Improved glycemic control and lipid profile in a randomized study of pioglitazone compared with acarbose in patients with type 2 diabetes mellitus. Treat. Endocrinol. 2002; 1(5): 329-36.
14. Pavo I., Jermendy G., Varkonyi T.T. et al.: Effect of pioglitazone compared with metformin on glycemic control and indicators of insulin sensitivity in recently diagnosed patients with type 2 diabetes. J. Clin. Endocrinol. Metab. 2003; 88(4): 1637-45.
15. Charbonnel B.H., Matthews D.R., Schernthaner G. et al.: A long term comparison of pioglitazone and gliclazide in patients with type 2 diabetes mellitus: a randomized, double-blind, parallel- group comparison trial. Diabet. Med. 2005; 22(4): 399-405.
16. Pfützner A., Marx N., Lübben G. et al.: Improvement of cardiovascular risk markers by pioglitazone is independent from glycemic control: results from the Pioneer study. J. Am. Coll. Cardiol. 2005; 45(12): 1925-31.
17. Einhorn D., Rendell M., Rosenzweig J. et al.: Pioglitazone hydrochloride in combination with metformin in the treatment of type 2 diabetes mellitus: a randomized, placebo-controlled study. The Pioglitazone 027 Study Group. Clin. Ther. 2000; 22(12): 1395-409.
18. Kipnes M.S., Krosnick A., Rendell M.S. et al.: Pioglitazone hydrochloride in combination with sulfonylurea therapy improves glycemic control in patients with type 2 diabetes mellitus: a randomized, placebo-controlled study. Am. J. Med. 2001; 111(1): 10-7.
19. Mattoo V., Eckland D., Widel M. et al.: Metabolic effects of pioglitazone in combination with insulin in patients with type 2diabetes mellitus whose disease is not adequately controlled with insulin therapy: results of a six-month, randomized, double-blind, prospective, multicenter, parallel-group study. Clin. Ther. 2005; 27: 554-67.
20. Goldberg R.B., Kendall D.M., Deeg M.A. et al.: A Comparison of Lipid and Glycemic Effects of Pioglitazone and Rosiglitazone in Patients With Type 2 Diabetes and Dyslipidemia. Diabetes Care 2005; 28: 1547-1554.
21. Promrat K., Lutchman G., Uwaifo G.I. et al.: A Pilot Study of Pioglitazone Treatment for Nonalcoholic Steatohepatitis. Hepatology 2004; 39: 188-196.
22. Yki-Järvinen H.: Thiazolidinediones and the liver in humans. Curr. Opin. Lipidol. 2009; 20(6): 477-83.
23. Naoumova P.R., Kindler H., Leccisotti L.: Pioglitazone Improves Myocardial Blood Flow and Glucose Utilization in Nondiabetic Patients With Combined Hyperlipidemia. JACC 2007; 50: 2051-8.
24. Derosa G.: Efficacy and Tolerability of Pioglitazone in Patients with Type 2 Diabetes Mellitus Comparison with Other Oral Antihyperglycaemic Agents. Drugs 2010; 70(15): 1945-1961.
25. Erdmann E., Spanheimer R., Charbonnel B.: Pioglitazone and the risk of cardiovascular events in patients with Type 2 diabetes receiving concomitant treatment with nitrates, renin–angiotensin system blockers, or insulin: results from the PROactive study (PROactive 20). Journal of Diabetes 2010; 2(3); 212-220.
26. Lincoff A.M., Wolski K., Nicholls S.J. et al.: Pioglitazone and Risk of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus A Meta-analysis of Randomized Trials JAMA. 2007; 298(10): 1180-1188.
27. Lewis J.D., Ferrara A., Peng T. et al.: Risk of Bladder Cancer Among Diabetic Patients Treated With Pioglitazone. Diabetes Care 2011; 34: 916-922.
28. Stanowisko FDA w sprawie ryzyka raka pęcherza moczowego związanego ze stosowaniem pioglitazonu [online].
29. Opinia EMA w sprawie stosowania pioglitazonu i związanym z tym ryzykiem raka pęcherza moczowego [online].
30. Nathan D.M., Buse J.B., Davidson M.B. et al.: Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2009; 32: 193-203.