Actos associated with lower stroke and heart attack risk in people with prediabetes

The type 2 diabetes drug Actos (pioglitazone) was found to be associated with lower risk of heart attacks and stroke in people with prediabetes who have experienced a stroke, according to Canadian researchers.
Actos is a once-daily oral medication for people with type 2 diabetes. It works by increasing the body’s sensitivity to its own insulin, allowing the hormone to work more effectively.
These new findings were based on an average period of nearly five years. A total of 2,885 people at high-risk of type 2 diabetes were involved, of all whom had suffered a stroke.
A team from Western University explored the impact of Actos as a secondary prevention for future stroke and heart attack. The results showed 33% lower risk of stroke and 40% lower composite risk of heart attack and stroke for those taking the drug compared to those taking a placebo.
There was an 80% reduction in new onset diabetes among those taking Actos compared with placebo.
Compared with those taking placebo, there was in increase in weight gain and edema in the group taking Actos and a slight increase in serious bone fractures.
The subgroup of people involved in the study had previously been involved in a study called the IRIS trial, a study of 3,876 people who had had a stroke or heart attack, and had insulin resistance. In this study, the group taking Actos experienced lowered recurrent stroke or heart attack by approximately a quarter.
The subgroup had even lower risks of complications when compared with those across the whole study, despite the subgroup including more smokers, people with high cholesterol levels and those with higher diastolic blood pressure.
Commenting on the study, Dr Leonardo Pantoni, of the University of Milan in Italy, said that medications liked Actos could help to prevent dementia.
He added: “The possibility of targeting this high-risk population might represent an appropriate approach to also prevent dementia linked with vascular brain changes.
“The availability of insulin resistance drugs might represent an opportunity to test for preventing other forms of dementia that are not immediately linked with cerebrovascular events.”
Dr Pantoni added that Actos is not currently being taken seriously as a secondary stroke prevention treatment because of links to bladder cancer and heart failure.
The study was published in the journal JAMA Neurology.
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