Actos lowers heart attack recurrence in diabetics

By Martha Kerr

DALLAS (Reuters Health) – The diabetes drug pioglitazone
(Actos; Takeda) significantly reduces the risk of heart attack
in type 2 diabetics who have already had a heart attack,
according to the results of a new study presented here
Wednesday.

At the American Heart Association’s Scientific Sessions
2005, Dr. Erland Erdmann of the University of Koln, Germany,
announced the findings of the PROactive study of the effects of
pioglitazone on recurrent heart attack. The study involved
2,445 type 2 diabetics who had experienced a heart attack at
least 6 months prior to enrollment.

Patients were randomly assigned to either conventional
optimal medical care or optimal care plus pioglitazone.
Follow-up averaged 3 years.

Erdmann said that improvements in high levels of blood
sugar, cholesterol and other cardiovascular risk factors showed
that all patients did in fact receive optimal care.

However, the addition of pioglitazone to optimal treatment
further reduced the risk of recurrent heart attack by 28
percent; the risk of acute coronary syndrome by 37 percent; and
the overall risk of a major coronary event, stroke or the need
for an invasive heart procedure by 19 percent. Acute coronary
syndrome usually involves unstable angina, a form of chest pain
that can signal an impending heart attack.

There is “no question” that adding pioglitazone to optimal
care improves patient outcomes, Erdmann said.

“We saw no drug interactions with the addition of
pioglitazone,” he told Reuters Health. Some patients had low
potassium levels, “but no actual side effects.”

Erdmann acknowledged that pioglitazone can cause fluid
retention, but none was seen in this trial.