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Diabetes Drug Curbs Arterial Thickening
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MONDAY, Nov. 13 (HealthDay News) -- A widely used diabetes drug may also slow the thickening of artery walls, a process which can lead to trouble later in life.
The drug, Actos (generic name pioglitazone), is currently prescribed to improve the body's sensitivity to insulin.
The study, which will appear in the Dec. 6 issue of the Journal of the American Medical Association, was released Monday to coincide with a presentation at the annual meeting of the American Heart Association, in Chicago.
People with diabetes have a higher risk of heart attacks. The risk can be reduced somewhat by controlling blood pressure and LDL ("bad") cholesterol, but experts say more intervention is needed.
"The importance of our study rests on the relationship between diabetes and heart attack and stroke," said Dr. Theodore Mazzone, of the University of Illinois at Chicago College of Medicine, at a Monday news conference. "Patients with diabetes have a two-to-four-fold increased risk and usually have a worse prognosis after a heart attack or stroke."
The study was funded by Takeda Pharmaceuticals, the maker of Actos.
Diabetes is also becoming more common in the United States, with one of every three people born now predicted to develop the disease during their lifetime.
For this study, 462 adults with type 2 diabetes in the greater Chicago area were randomly assigned to receive a daily dose of Actos or Amaryl (glimepiride) for 72 weeks.
Amaryl also lowers blood sugar but works by a different mechanism than Actos.
At the end of the treatment period, the carotid artery intima-media (CIMT) thickness -- a measure of the thickness of the middle layers of the carotid arteries -- increased by an average of .012 millimeters in participants taking glimepiride and decreased by .001 millimeters in those taking pioglitazone.
"The CIMT is one of the layers that becomes thickened in the earliest stages of atherosclerosis, and many past studies have shown that the thicker your CIMT, the higher your rate of heart attack and stroke in the next 5 to 10 years," said Mazzone. "The faster this layer thickens, the higher the risk of heart attack and stroke over the next 5 to 10 years."
In essence, the study found that Actos was more beneficial than Amaryl in reducing CIMT.
"It means that pioglitazone could be part of a novel strategy for managing residual cardiovascular risk in patients with type 2 diabetes," Mazzone said.
Mazzone emphasized that CIMT thickness was a surrogate endpoint and that the results could not yet be taken to mean there would be a reduction in actual clinical events for patients.
SOURCES: Nov. 13, 2006, news conference with Theodore Mazzone, M.D., University of Illinois at Chicago College of Medicine; Dec. 6, 2006, Journal of the American Medical Association
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