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Diabetes Drug Stalls Heart Disease

Posted on: Monday, 13 November 2006, 18:00 CST

By ED SUSMAN

A commonly prescribed drug to treat diabetes apparently prevents changes in the walls of blood vessels -- changes that may lead to heart attacks and strokes, U.S. researchers said Monday.

We were able to seen beneficial effect of pioglitazone (Actos) on patients with diabetes whether they are older or younger, men or women, overweight or not, said Theodore Mazzone, professor of medicine at the University of Illinois, Chicago.

Mazzone enrolled 462 patients in his study that involved imaging the carotid arteries in the neck of patients with high resolution imaging ultrasound.

Then, 72 weeks later the patients' necks were again imaged with ultrasound. Mazzone said that patients on pioglitazone had virtually no changes in the thickness of the artery cell wall. Among patients taking another diabetes drug, glimepiride (Amaryl), there was an increase of 0.012 mm.

While that difference was small, it was significantly larger than with pioglitazone, Mazzone said Monday at the 79th annual meeting of the American Medical Association in Chicago.

Patients with diabetes are at increased risk for cardiovascular disease resulting from atherosclerosis (hardening of the arteries), he said. The carotid artery thickening is an indicator of risk for heart attack and stroke.

What this study indicates is that we may be able to slow the progression of this disease which leads to heart attacks, said Jennifer Mieres, associate professor of medicine at New York University School of Medicine and a spokesperson for the AHA.

This is a promising study, she told United Press International. A major strength of this study is that it is a real-world group of patients. About 66 percent of the patients in this study were women, and many of them are Hispanic and other minorities. These are the people who get diabetes in this country.

Mieres said pioglitazone may be ready to join other treatments that include use of aspirin, another class of heart drugs known as beta blockers and cholesterol-lowering agents called statins into an attack on atherosclerosis that may be able to prevent the disease in people or slow it in those people where the disease already has a foothold.

Mieres said that when atherosclerosis appears in the carotid arteries -- major blood vessels that supply blood to the brain -- it is generally assumed that the disease process extends throughout the body, including the coronary arteries that nourish the heart. Therefore, by preventing atherosclerosis in the carotid arteries, pioglitazone may be benefiting the heart arteries as well.

However, Mieres said that despite the promise shown in the new study, it's not yet time to be putting these drugs into the drinking water.

As with all medications, pioglitazone has adverse side effects. Mazzone also said that confirmatory studies are needed before the results can be generalized to the public as a whole.

Source: United Press International

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