Hormonal
PPARγ agonist pioglitazone significantly reduces the risk of major cardiovascular events (stroke and myocardial infarction) in patients with type 2 diabetes and high cardiovascular risk, including those with prediabetes.
If you have type 2 diabetes and are at high risk for heart issues, ask your doctor about pioglitazone. It has been shown in multiple studies to significantly lower the risk of stroke and heart attack, even in people with prediabetes. While it can cause side effects like weight gain or swelling, the cardiovascular protection it offers is substantial for high-risk individuals.
a recent meta-analyses of ten randomized control trials (RCTs) reinforced the finding that the treatment with pioglitazone can lower the risk for major cardiovascular events by approximately 26% [108]. ... the IRIS trial discovered that the cardioprotective effect of pioglitazone was considerable even in prediabetes patients, whereby a 24% risk reduction in stroke and myocardial infarction was observed among those treated with pioglitazone compared to placebo [96].
Why this rating
Supported by a meta-analysis of 10 RCTs and a specific large-scale trial (IRIS), indicating high-quality clinical evidence.
Source
Exploration and Development of PPAR Modulators in Health and Disease: An Update of Clinical Evidence
Hong Sheng Cheng et al. · International Journal of Molecular Sciences · 2019
DOI 10.3390/ijms20205055
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- Dual-PPARα/γ agonists (glitazars) like muraglitazar, tesaglitazar, and aleglitazar have largely failed in clinical development for type 2 diabetes and cardiovascular disease due to severe safety concerns, including heart failure, renal dysfunction, and increased mortality.Strong
- PPARα agonists (fibrates) significantly reduce cardiovascular events and myocardial infarction in subjects without existing cardiovascular disease, making them effective for primary prevention.Good
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