Revitalization of Pioglitazone: The Optimal Agent to be Combined with an SGLT2 Inhibitor

ABSTRACT The recently completed EMPA‐REG study demonstrated that empagliflozin significantly decreased the MACE endpoint (cardiovascular death, nonfatal MI, stroke) in high risk type 2 diabetic patients, primarily due to a reduction in cardiovascular death, without a significant decrease in either myocardial infarction or stroke. In PROactive, pioglitazone decreased the MACE endpoint by a similar degree to that in EMPA‐REG, due to a marked reduction in both recurrent myocardial infarction and stroke and a modest reduction in cardiovascular death. These observations suggest that pioglitazone might be an ideal agent to combine with empagliflozin to further reduce cardiovascular events in high risk diabetic individuals since empagliflozin also promotes salt/water loss and would be expected to offset any fluid retention associated with pioglitazone therapy. Herein, we provide an overview of the potential benefits of combined pioglitazone/empagliflozin therapy to prevent cardiovascular events in patients with type 2 diabetes mellitus.
Source: Diabetes, Obesity and Metabolism - Category: Endocrinology Authors: Tags: ORIGINAL ARTICLE Source Type: research