Diabetes drug may prevent heart attack, recurring stroke

Actos decreased the number of cardiovascular events in previous stroke patients by nearly a quarter during a five-year clinical trial.
By Stephen Feller  |  Feb. 17, 2016 at 4:46 PM
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NEW HAVEN, Conn., Feb. 17 (UPI) -- The diabetes drug pioglitazone, sold as Actos, was shown to lower the risk of recurring stroke and heart attack in a large clinical trial of insulin-resistant stroke patients.

Researchers at Yale University found the drug decreased the number of cardiovascular events in previous stroke patients by nearly a quarter during the five-year trial.

Pioglitazone has been shown in previous studies to prevent stroke and heart attack in patients with type 2 diabetes, as well as patients who have trouble processing sugar but are not diabetic, but has been controversial because of increased risks for heart failure and edema, as well as weight gain.

Another study in 2006 showed the drug reduced risk for heart attack and stroke, but not in those who had not had a previous stroke.

"This study represents a novel approach to prevent recurrent vascular events by reversing a specific metabolic abnormality thought to increase the risk for future heart attack or stroke," said Dr. Walter Koroshetz, director of the National Institute of Neurological Disorders and Stroke, in a press release.

For the study, published in the New England Journal of Medicine, researchers enrolled 3,876 people in seven countries at 167 insistutions to receive either 45 milligram doses of pioglitazone or a placebo. All patients recruited for the study did not have diabetes but were insulin-resistant for five years.

Nine percent of patients who received the drug had either a stroke or heart attack, while 11.8 percent who were given a placebo had either one. Far fewer patients taking the drug developed diabetes, 3.8 percent, compared to 7.7 percent of placebo patients who developed type 2 diabetes.

The researchers noted the drug increased risk for weight gain, edema and bone fracture, which they said future work would focus on mitigating.

"After years of controversy, pioglitazone is now proven to have cardiovascular benefits," said Dr. Silvio Inzucchi, an endocrinologist at Yale University, said in a press release. "It's exciting to think that metabolic therapy may now be poised to take its place beside aspirin and cholesterol- and blood pressure-lowering therapies for preventing stroke in non-diabetic patients."

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