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Impact of treatment with pioglitazone on stroke outcomes: A real ‐world database analysis
Diabetes, Obesity and Metabolism, EarlyView.
Source: Diabetes, Obesity and Metabolism - June 4, 2018 Category: Endocrinology Authors: Christopher Ll Morgan MSc , Silvio E. Inzucchi MD , Jorge Puelles MSc , Sara Jenkins ‐Jones MSc , Craig J. Currie PhD Source Type: research

Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack.
CONCLUSIONS: Peroxisome proliferator-activated receptor gamma agonists probably reduce recurrent stroke and total events of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, and may improve insulin sensitivity and the stabilisation of carotid plaques. Their effects on adverse events are uncertain. Our conclusions should be interpreted with caution considering the small number and the quality of the included studies. Further well-designed, double-blind RCTs with large samples are required to assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular...
Source: Cochrane Database of Systematic Reviews - December 2, 2017 Category: General Medicine Authors: Liu J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Which Patients With Ischemic Stroke and Insulin Resistance May Benefit From Pioglitazone?
The Insulin Resistance Intervention After Stroke (IRIS) trial has reported that treating insulin resistance with the peroxisome proliferator –activated receptor γ agonist pioglitazone hydrochloride reduced recurrent stroke or myocardial infarction (MI) by about one-fourth compared with placebo (pioglitazone, 9.0% vs placebo, 11.8%; hazard ratio [HR], 0.76; 95% CI, 0.62-0.93) in 3876 patients with recent (<6 months) ischemic stroke or transient ischemic attack and insulin resistance but without diabetes, heart failure, or bladder cancer. Pioglitazone was also associated with less incident diabetes vs placebo (3.8% vs ...
Source: JAMA Neurology - November 1, 2017 Category: Neurology Source Type: research

Pioglitazone Prevents Stroke in Patients with a Recent TIA or Ischemic Stroke: A Planned Secondary Analysis of the IRIS Trial.
Conclusions -Pioglitazone was effective for secondary prevention of ischemic stroke in non-diabetic patients with insulin resistance. Clinical Trial Registration -URL: http://www.clinicaltrials.gov. Unique identifier: NCT00091949. PMID: 29084736 [PubMed - as supplied by publisher]
Source: Circulation - October 30, 2017 Category: Cardiology Authors: Yaghi S, Furie KL, Viscoli CM, Kamel H, Gorman M, Dearborn J, Young LH, Inzucchi SE, Lovejoy AM, Kasner SE, Conwit R, Kernan WN, IRIS Trial Investigators Tags: Circulation Source Type: research

Depression in the Context of Medical Disorders: New Pharmacological Pathways Revisited
In conclusion a hypothetic model for the implication of actual findings in everyday clinical practice is proposed. In this context personalized treatment could be used to tailor treatment to specific individuals according to their clinical endophenotypes. Moreover a potential target for the development of novel intervention strategies might be used.Neurosignals 2017;25:54 –73
Source: Neurosignals - October 25, 2017 Category: Neurology Source Type: research

Pioglitazone Improves Left Ventricular Diastolic Function in Subjects With Diabetes
CONCLUSIONS Pioglitazone improves whole-body and myocardial insulin sensitivity, LV diastolic function, and systolic function in T2D. Improved myocardial insulin sensitivity and diastolic function are strongly correlated.
Source: Diabetes Care - October 23, 2017 Category: Endocrinology Authors: Clarke, G. D.; Solis-Herrera, C.; Molina-Wilkins, M.; Martinez, S.; Merovci, A.; Cersosimo, E.; Chilton, R. J.; Iozzo, P.; Gastaldelli, A.; Abdul-Ghani, M.; DeFronzo, R. A. Tags: Epidemiology-Diabetes Complications Pathophysiology/Complications Source Type: research

Depression in the Context of Medical Disorders: New Pharmacological Pathways Revisited
In conclusion a hypothetic model for the implication of actual findings in everyday clinical practice is proposed. In this context personalized treatment could be used to tailor treatment to specific individuals according to their clinical endophenotypes. Moreover a potential target for the development of novel intervention strategies might be used.Neurosignals 2017;25:54 –73
Source: Neurosignals - October 17, 2017 Category: Neurology Source Type: research

Response by Young et al to Letters Regarding Article, "Cardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack: Effects of Pioglitazone in Patients With Insulin Resistance Without Diabetes Mellitus".
PMID: 29038213 [PubMed - in process]
Source: Circulation - October 17, 2017 Category: Cardiology Authors: Young LH, Viscoli CM, Inzucchi SE, Kernan WN Tags: Circulation Source Type: research

Letter by Jin-Shan and Xue-Bin Regarding Article, "Cardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack: Effects of Pioglitazone in Patients With Insulin Resistance Without Diabetes Mellitus".
PMID: 29038212 [PubMed - in process]
Source: Circulation - October 17, 2017 Category: Cardiology Authors: Jin-Shan H, Xue-Bin L Tags: Circulation Source Type: research

Letter by Musso et al Regarding Article, "Cardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack: Effects of Pioglitazone in Patients With Insulin Resistance Without Diabetes Mellitus".
PMID: 29038211 [PubMed - in process]
Source: Circulation - October 17, 2017 Category: Cardiology Authors: Musso G, Cassader M, Gambino R Tags: Circulation Source Type: research

Depression in the Context of Medical Disorders: New Pharmacological Pathways Revisited.
In conclusion a hypothetic model for the implication of actual findings in everyday clinical practice is proposed. In this context personalized treatment could be used to tailor treatment to specific individuals according to their clinical endophenotypes. Moreover a potential target for the development of novel intervention strategies might be used. PMID: 29041003 [PubMed - as supplied by publisher]
Source: Neuro-Signals - October 17, 2017 Category: Neurology Authors: Lang UE, Walter M Tags: Neurosignals Source Type: research

Antidiabetic drugs and stroke risk. Current evidence.
Abstract Cardiovascular disease (CVD) is the major cause of morbidity and mortality for individuals with type 2 diabetes (T2D). In particular, the risk for stroke is twice that of patients without diabetes, and diabetes may be responsible for >8% of first ischemic strokes. Therefore, the way to prevent stroke in these patients has become an important issue. Traditionally, glucose-lowering drugs had not been shown to protect against stroke. Moreover, several antidiabetic drugs (i.e., sulfonylureas, rosiglitazone) have been reported to be associated with increased risks of CVD and stroke. On the contrary, data on...
Source: European Journal of Internal Medicine - September 20, 2017 Category: Internal Medicine Authors: Castilla-Guerra L, Fernandez-Moreno MDC, Leon-Jimenez D, Carmona-Nimo E Tags: Eur J Intern Med Source Type: research

Which Patients With Ischemic Stroke and Insulin Resistance May Benefit From Pioglitazone?
The Insulin Resistance Intervention After Stroke (IRIS) trial has reported that treating insulin resistance with the peroxisome proliferator –activated receptor γ agonist pioglitazone hydrochloride reduced recurrent stroke or myocardial infarction (MI) by about one-fourth compared with placebo (pioglitazone, 9.0% vs placebo, 11.8%; hazard ratio [HR], 0.76; 95% CI, 0.62-0.93) in 3876 patients with recent (<6 months) ischemic stroke or transient ischemic attack and insulin resistance but without diabetes, heart failure, or bladder cancer. Pioglitazone was also associated with less incident diabetes vs placebo (3.8% vs ...
Source: JAMA Neurology - September 18, 2017 Category: Neurology Source Type: research

Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial
This study is registered with ClinicalTrials.gov, number NCT00700856. Findings Between Sept 18, 2008, and Jan 15, 2014, 3028 patients were randomly assigned and included in the analyses. 1535 were assigned to pioglitazone and 1493 to sulfonylureas (glibenclamide 24 [2%], glimepiride 723 [48%], gliclazide 745 [50%]). At baseline, 335 (11%) participants had a previous cardiovascular event. The study was stopped early on the basis of a futility analysis after a median follow-up of 57·3 months. The primary outcome occurred in 105 patients (1·5 per 100 person-years) who were given pioglitazone and 108 (1·5 per 100 person-yea...
Source: The Lancet Diabetes and Endocrinology - September 14, 2017 Category: Endocrinology Source Type: research

Glucagon-like peptide-1 agonists and protection against stroke: A systematic review and meta-analysis
Aim: Type 2 diabetes is associated with an increased risk of stroke and a worse outcome following stroke. Among glucose-lowering modalities only pioglitazone (a thiazolinedione) has been shown to protect against stroke. Nonetheless, evidence from experimental with novel antidiabetic agents, such as glucagon-like peptide-1 (GLP-1) agonists, suggests potential neuroprotective effects, especially if treatment starts before stroke. Thus, we aimed to meta-analyze available evidence regarding the risk of stroke in individuals receiving GLP-1 agonists.
Source: Atherosclerosis - August 1, 2017 Category: Cardiology Authors: Fotios Barkas, Moses Elisaf, Haralampos Milionis Source Type: research

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