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PROactive 07: pioglitazone in the treatment of type 2 diabetes: results of the PROactive study

Authors Erland Erdmann, John Dormandy, Robert Wilcox, Massimo Massi-Benedetti, Bernard Charbonnel

Published 15 September 2007 Volume 2007:3(4) Pages 355—370

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Erland Erdmann1, John Dormandy2, Robert Wilcox3, Massimo Massi-Benedetti4, Bernard Charbonnel5

1University of Cologne, Cologne, Germany; 2Department of Clinical Vascular Research, St Georges Hospital, London, UK; 3Department of Cardiovascular Medicine, Queen’s Medical Centre, University Hospital, Nottingham, UK; 4University of Perugia, Medicine and Metabolic Diseases, Perugia, Italy; 5Clinique d’Endocrinologie, Hôtel Dieu, Nantes Cedex 1, France

Abstract: Patients with type 2 diabetes face an increased risk of macrovascular disease compared to those without. Significant reductions in the risk of major cardiovascular events can be achieved with appropriate drug therapy, although patients with type 2 diabetes remain at increased risk compared with non-diabetics. The thiazolidinedione, pioglitazone, is known to offer multiple, potentially antiatherogenic, effects that may have a beneficial impact on macrovascular outcomes, including long-term improvements in insulin resistance (associated with an increased rate of atherosclerosis) and improvement in the atherogenic lipid triad (low HDL-cholesterol, raised triglycerides, and a preponderance of small, dense LDL particles) that is observed in patients with type 2 diabetes. The recent PROspective pioglitAzone Clinical Trial In macroVascular Events (PROactive) study showed that pioglitazone can reduce the risk of secondary macrovascular events in a high-risk patient population with type 2 diabetes and established macrovascular disease. Here, we summarize the key results from the PROactive study and place them in context with other recent outcome trials in type 2 diabetes.

Keywords: pioglitazone, macrovascular disease, type 2 diabetes, secondary prevention

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