RE: [IP] Diabetes Drug Slows Clogging of Arteries
Which one is right????
Cleveland Clinic Study Shows the Diabetes Drug Pioglitazone Reduces Risk of
Death, Heart Attack and Stroke But Increases Risk of Heart Failure
Results Appear in the Sept. 12 Issue of the Journal of the American Medical
A drug widely used to treat type 2 diabetes has been found to reduce the
risk of death, heart attack (myocardial infarction) or stroke when used
alone or in combination with other therapies for diabetes, according to a
Cleveland Clinic study. The study published in the Sept. 12 issue of the
Journal of the American Medical Association reports that use of pioglitazone
(ActosT) is associated with a significantly lower risk of death, myocardial
infarction, or stroke among a diverse population of diabetic patients.
In a meta-analysis of 19 trials comprising 16,390 patients, researchers
found that 4.4% (375) of the 8,554 patients prescribed pioglitazone either
died or suffered a heart attack or stroke compared 5.7% (450) of 7,836
patients in a control group who received a placebo or other anti-diabetic
therapy. The study also showed that patients receiving pioglitazone were
more likely to experience fluid retention leading to serious heart failure,
although this risk did not diminish the favorable effect of the drug on
cardiac death or heart attack. Investigation of the cardiovascular effects
of anti-diabetic therapies is critical because more than 65% of the deaths
among diabetic patients are attributed to heart disease.
"The findings in this study suggest that pioglitazone provides
cardiovascular benefits to diabetic patients beyond its effect on lowering
blood sugar, with important reductions in the risk of death, heart attack or
stroke among patients who receive this drug," said A. Michael Lincoff, M.D.,
Vice Chairman for Research in the Department of Cardiovascular Medicine at
Cleveland Clinic. "Similarly, the results indicate that the potential for
serious heart failure does not diminish the drug's overall effectiveness and
benefit to patients."
To carry out the research, the drug's manufacturer, Takeda of Lincolnshire,
Ill., transferred a database containing individual patient data collected
during clinical trials of pioglitazone to Cleveland Clinic's Cardiovascular
Coordinating Center for independent analysis. Although funding was provided,
the company played no role in conducting the analysis. All the studies were
randomized, double-blinded, and controlled with placebo or active
comparator. The period of time in which patients received treatment ranged
from four months to 3.5 years. In addition to Dr. Lincoff, researchers
involved in the study included Stephen J. Nicholls, M.B.B.S., Ph.D., a
Cleveland Clinic cardiologist; Steven Nissen, M.D., Chairman of the
Department of Cardiovascular Medicine at Cleveland Clinic; and Cleveland
Clinic statistician, Kathy Wolski.
The study of pioglitazone follows a meta-analysis Dr. Nissen and Ms. Wolski
conducted earlier this year on the use of rosiglitazone (AvandiaT), another
commonly used diabetes drug. In his analysis of 42 clinical trials, Dr.
Nissen found that rosiglitazone raised patients' risk of heart attack and
cardiovascular death by 43% and 64%, respectively in comparison to the use
of a placebo or other anti-diabetes therapy.
Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit
multispecialty academic medical center that integrates clinical and hospital
care with research and education. Cleveland Clinic was founded in 1921 by
four renowned physicians with a vision of providing outstanding patient care
based upon the principles of cooperation, compassion and innovation. U.S.
News & World Report consistently names Cleveland Clinic as one of the
nation's best hospitals in its annual "America's Best Hospitals" survey.
Approximately 1,800 full-time salaried physicians and researchers at
Cleveland Clinic and Cleveland Clinic Florida represent more than 100
medical specialties and subspecialties. In 2006, there were 3.1 million
outpatient visits to Cleveland Clinic. Patients came for treatment from
every state and from more than 80 countries. There were more than 53,000
hospital admissions to Cleveland Clinic in 2006. Cleveland Clinic's Web site
address is www.clevelandclinic.org.
C Copyright 2007 The Cleveland Clinic Foundation. All rights reserved.
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Sent: Monday, March 31, 2008 3:23 PM
To: Insulin-Pumpers; email @ redacted;
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Subject: [IP] Diabetes Drug Slows Clogging of Arteries
Diabetes Drug Slows Clogging of Arteries
Actos better at fighting plaque build-up than older medication, study finds
By Amanda Gardner
MONDAY, March 31 (HealthDay News) -- The diabetes drug Actos is better than
another diabetes drug, Amaryl, at slowing clogging of the arteries in
patients with both type 2 diabetes and cardiovascular disease.
The Cleveland Clinic researchers behind the new findings say this is the
first time that a diabetes medication has been shown to slow
atherosclerosis, giving doctors new insight into which drugs may be most
effective and safest for this group of patients.
"As we go forward, the study tells us that we must do comparative
effectiveness trials looking at different diabetes strategies," study author
Steve Nissen, chairman of the department of cardiovascular medicine at
Cleveland Clinic, said Monday. "We can't just focus on pricking your finger,
getting blood sugar down. The goal in diabetes therapy is to prevent
complications, and the most feared complication is heart disease, which will
kill 75 percent of all diabetics. I'm thrilled with results."
Another expert hailed the results.
"The biggest news here is that pioglitazone [Actos] appears safe, does not
increase cardiovascular risk, and may even reduce it," said Dr. Robert Scott
III, an assistant professor of internal medicine at the Texas A&M Health
Science Center College of Medicine and senior staff cardiologist with
Scott&White in Temple, Texas. "It looks safe to use in people with coronary
artery disease, and it is well-tolerated. We may need another trial to see
how it helps, but at least it doesn't hurt, and that was our biggest
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