Physicians' Academy for Cardiovascular Education

Pioglitazone: Where do we stand in 2011

Slides (presentation) - Oct. 18, 2011

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

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