Diabetes Drug, Actos, May Help Prevent Second Stroke

“Among insulin-resistant, non-diabetic patients with ischemic stroke or TIA, pioglitazone prevented stroke or MI, with an absolute risk reduction of 2.9% and relative risk reduction of 24%, and diabetes, with an absolute risk reduction of 3.9% and a relative risk reduction of 52%”, Kernan said.

A new study suggests that the diabetes drug Actos (pioglitazone) might protect people from suffering a second stroke, nwitimes reports.

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. Insulin regulates metabolism and keeps the blood sugar from getting too high.

The diabetes drug pioglitazone (Actos) works by addressing the body’s insulin resistance.

“After years of controversy, pioglitazone is now proven to have cardiovascular benefits”, says Dr. Silvio Inzucchi, from Yale University.

“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”, he added.

For the objective of the study, researchers recruited more than 3000 patients from seven countries with an history of ischemic stroke or transient ischemic attack within the previous six months. Patients were randomly assigned in a 1:1 ratio to receive either pioglitazone or placebo, with treatment initiated at 15 mg/day and titrated to 45 mg/day over 12 weeks.

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.

The results estimated that 28 strokes or heart attacks occurrences might be averted for every 1000 individuals who take pioglitazone for five years. The study participants didn’t have diabetes but were insulin-resistant for five years.

While this new found use of Pioglitazone is commendable, the drug’s use in the IRIS trial was not approved by the Food and Drug Administration. The researchers acknowledged that further studies will need to be carried out to determine the mechanisms by which the medication actually decreases heart attack and stroke risk.

Kernan explained they want to find safer methods to administer the drug so as to increase the benefits and reduce the risks to minimum. To help doctors and patients choose the best strategy for preventing recurring strokes, future studies will attempt to identify a person’s risk of bone fractures due to pioglitazone.

Notably, patients taking pioglitazone had more weight gain, edema, shortness of breath, and bone fractures-a known side effect of the drug-than patients in the placebo group. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases.