Revitalization of pioglitazone: the optimum agent to be combined with a sodium‐glucose co‐transporter‐2 inhibitor

The recently completed EMPA‐REG study showed that empagliflozin significantly decreased the major adverse cardiac events (MACE) endpoint, which comprised cardiovascular death, non‐fatal myocardial infarction (MI) and stroke, in patients with high‐risk type 2 diabetes (T2DM), primarily through a reduction in cardiovascular death, without a significant decrease in either MI or stroke. In the PROactive study, pioglitazone decreased the MACE endpoint by a similar degree to that observed in the EMPA‐REG study, through a marked reduction in both recurrent MI 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 patients with high‐risk diabetes as empagliflozin also promotes salt/water loss and would be expected to offset any fluid retention associated with pioglitazone therapy. In the present paper, we provide an overview of the potential benefits of combined pioglitazone/empagliflozin therapy to prevent cardiovascular events in patients with T2DM.
Source: Diabetes, Obesity and Metabolism - Category: Endocrinology Authors: Tags: PERSPECTIVE Source Type: research