| アブストラクト | AIMS: Randomized controlled trials have reported an association between pioglitazone and reduced incidence of stroke in type 2 diabetic (T2DM) and insulin-resistant populations. We investigated this association within a real-world database. MATERIALS AND METHODS: T2DM patients who initiated pioglitazone between 2000 and 2012 were extracted from the Clinical Practice Research Datalink (CPRD), a UK routine data source. Two non-exposed control cohorts were matched according to age, gender, HbA1c, diabetes duration, stroke history, co-morbidities and prior T2DM regimen. Control cohort-1 comprised patients initiating a new T2DM therapy as their respective case initiated pioglitazone. Control cohort-2 maintained the same T2DM regimen as their respective case prior to the case initiating pioglitazone. Primary outcome was incident stroke; other outcomes included mortality, length of hospital stay and stroke recurrence. RESULTS: A total of 4234 patients initiating pioglitazone were matched to controls in cohort-1 and 3604 in cohort-2. For the primary outcome there were significantly reduced hazard ratios (HRs) for cases: controls. For cohort 1, the HR was 0.666 (95% CI, 0.466-0.952) during the therapy period and was 0.750 (0.612-0.919) over the entire observation period; for cohort 2, respective HRs were 0.516 (0.336-0.794) and 0.773 (0.611-0.978). There was no significant difference in 30-day mortality rate or rate of recurrent stroke. For stroke events that required hospitalization, there was a significant difference in length of stay for patients discharged to usual residence (median, 3.0 days vs 7.0 days; P = .008) for control cohort-2 while undergoing treatment. CONCLUSIONS: In support of evidence from 2 large randomized trials, these observational data show that pioglitazone has a potent effect in reducing stroke events in patients with type 2 diabetes. |
|---|
| ジャーナル名 | Diabetes, obesity & metabolism |
|---|
| Pubmed追加日 | 2018/5/8 |
|---|
| 投稿者 | Morgan, Christopher Ll; Inzucchi, Silvio E; Puelles, Jorge; Jenkins-Jones, Sara; Currie, Craig J |
|---|
| 組織名 | Pharmatelligence, Cardiff, UK.;Internal Medicine, Yale School of Medicine, New Haven, Connecticut.;Takeda, London, UK.;Institute of Population Medicine, School of Medicine, Cardiff University,;Cardiff, UK. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/29732718/ |
|---|
