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ACC: Drug May Slow Atherosclerosis in Diabetics

Pioglitazone is first hypoglycemic drug shown to impact atherosclerotic progress

MONDAY, March 31 (HealthDay News) -- Among patients with type 2 diabetes and coronary artery disease, treatment with pioglitazone may slow progression of coronary atherosclerosis, according to research published online March 31 in the Journal of the American Medical Association and presented at the American College of Cardiology's 57th Annual Scientific Session held this week in Chicago.

Steven E. Nissen, M.D., of the Cleveland Clinic Foundation in Ohio, and colleagues randomized 543 patients with coronary artery disease and type 2 diabetes from 97 North and South American academic and community hospitals to receive glimepiride or pioglitazone for 18 months, titrated to a maximum dosage, if tolerated. Coronary intravascular ultrasound was performed at baseline and at study completion to measure progression of atherosclerosis.

A measure of atherosclerotic progression, least squares change in mean percent atheroma volume, increased by 0.73 percent in the glimepiride group and decreased by 0.16 percent in the pioglitazone group, the researchers report. In addition, pioglitazone was associated with modest improvements in hemoglobin A1c levels, favorable changes in high-density lipoprotein and triglyceride levels, and lower median fasting insulin levels, compared to glimepiride.

"The observation of a significant benefit for pioglitazone treatment represents, to our knowledge, the first demonstration of the ability of any hypoglycemic agent to slow the progression of coronary atherosclerosis in patients with diabetes," the authors conclude.

This study was funded by Takeda Pharmaceuticals North America Inc.

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