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Pioglitazone: Where do we stand in 2011?
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Use of Pioglitazone
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Bladder Cancer: Clinical Trials
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Bladder Cancer: Epidemiological Studies
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KPNC Study
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KPNC 3rd Interim Analysis
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Strengths and Limitations of KPNC Study
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CNAMTS Overall Results
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Results of Other Cancers Reported in CNAMTS Study
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Overall Malignancies
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Bladder Cancer Conclusions
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Slide 12
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TZDs are activators of PPAR gamma?
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Patho-physiology of Type 2 diabetes
Site of Action of Available Drugs
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Free Fatty Acids: Insulin Resistance, IGT and Type 2 NIDDM
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Pioglitazone 30-45 mg/d Reduces Plasma Glucose, Insulin and FFA and Increase Adiponectin in Diabetes
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NASH
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ALT
U/L
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Post hoc analysis of the PROactive study: Effect of pioglitazone added to
metformin monotherapy (n=514) or sulphonylurea monotherapy (n=1001)
Effects on Glycated haemoglobin
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Post hoc analysis of the PROactive study
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Post hoc analysis of PROactive
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Slide 22
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Pioglitazone
+ existing therapy
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Time to Primary Composite Endpoint
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PROactive Total Events
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Slide 26
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Time to : Death, MI ( excluding silent ) or Stroke
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In high-risk patients with type 2 diabetes and previous MI, pioglitazone significantly reduced the occurrence of recurrent fatal and nonfatal MI and ACS
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Time to Fatal/Non-fatal MI
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In high-risk patients with type 2 diabetes and previous stroke, pioglitazone significantly reduced the occurrence of recurrent fatal and nonfatal stroke.
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Time to Fatal or Non-Fatal Stroke in Patients with Previous Stroke
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eso-stroke.org
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Am Soc Nephrol 19: 182–187, 2008
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Am Soc Nephrol 19: 182–187, 2008
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JAMA 2007; 298 : 1180-1188
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Carotid Intima–Media Thickness (CIMT)
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CHICAGO: Glycaemic Control Change in HbA1c
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CHICAGO: Treatment effect on posterior wall mean CIMT
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Will pioglitazone stabilize carotid artery vulnerable plaque in patients with acute coronary syndromes (ACS) and type 2 diabetes?
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PreTreatment
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Intravascular Ultrasound
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PERISCOPE IVUS Trial Primary Endpoint: Change in % Atheroma Volume
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PERISCOPE: Comparison to Other Trials
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Benefits of Pioglitazone: Lipid Metabolism
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Slide 45
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Intravascular Ultrasound of Coronary Arteries
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PROactive Metabolic Effects of Pioglitazone
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Pioglitazone and heart failure
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The Development of Heart failure on Pioglitazone in PROactive did not affect subsequent prognosis
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Fluid Retention and Site of Action of Diuretics
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Slide 51
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Insulin-Mediated Glucose Uptake in Myocardium PET Scan and F-18 labelled Fluoro-deoxyglucose
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Whole body glucose disposal and Myocardial glucose utilization during hyperinsulinaemic clamp FDG uptake using Positron Emission Tomography
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Hyperaemic Myocardial Blood Flow Before and After Pioglitazone
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Slide 56
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Burden in T2DM: Events in Controlled Clinical Studies
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ADA/EASD Algo rhythm
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