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Pioglitazone for Secondary Stroke Prevention Clinical Sciences
Conclusions—Pioglitazone reduces recurrent stroke and major vascular events in ischemic stroke patients with insulin resistance, prediabetes, and diabetes mellitus.
Source: Stroke - January 22, 2017 Category: Neurology Authors: Meng Lee, Jeffrey L. Saver, Hung-Wei Liao, Chun-Hsien Lin, Bruce Ovbiagele Tags: Cardiovascular Disease, Diabetes, Type 2, Secondary Prevention, Meta Analysis, Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Hyperglycemia and PPAR{gamma} Antagonistically Influence Macrophage Polarization and Infarct Healing After Ischemic Stroke Basic Sciences
Conclusions— Hyperglycemia and macrophage-specific PPAR activation exert opposing effects on MO/MP polarization in ischemic stroke lesions and, thereby, critically determine the risk of hemorrhagic infarct transformation.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Gliem, M., Klotz, L., van Rooijen, N., Hartung, H.-P., Jander, S. Tags: Animal models of human disease, Coumarins, Other diabetes, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Anticoagulants Basic Sciences Source Type: research

Sodium-Glucose Cotransporter-2 Inhibitors and Protection Against stroke in Patients with type 2 Diabetes and Impaired Renal Function: A Systematic Review and Meta-Analysis
It is well established that diabetes mellitus type 2 (T2DM) is associated with increased risk of cardiovascular disease, including ischemic stroke. Among past antidiabetic agents, only pioglitazone and glucagon-like peptide 1 receptor agonists (GLP-1RA) have been shown to decrease the risk of stroke.1-5 Similarly, sodium-glucose cotransporter-2 inhibitors (SGLT2i) were expected to reduce the risk of stroke, considering their blood pressure lowering and neuroprotective effects demonstrated by experimental studies.
Source: Journal of Stroke and Cerebrovascular Diseases - March 10, 2021 Category: Neurology Authors: Fotios Barkas, Sebastian Filippas Ntekouan, Evangelos Liberopoulos, Theodosios Filippatos, Haralampos Milionis Source Type: research

Letter by Castilla-Guerra et al Regarding Article, “Pioglitazone for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis” Letter to the Editor
Source: Stroke - April 24, 2017 Category: Neurology Authors: Luis Castilla–Guerra, Maria del Carmen Fernandez–Moreno, Jose Antonio Perez de Leon Tags: Diabetes, Type 2, Risk Factors, Secondary Prevention, Cerebrovascular Disease/Stroke, Vascular Disease Letters to the Editor Source Type: research

Letter by Iguchi and Nango Regarding Article, “Pioglitazone for Secondary Stroke Prevention: A Systematic Review and Meta-Analysis” Letter to the Editor
Source: Stroke - June 26, 2017 Category: Neurology Authors: Masahiro Iguchi, Eishu Nango Tags: Diabetes, Type 2, Secondary Prevention, Cerebrovascular Disease/Stroke Letters to the Editor Source Type: research

Medical Management for Secondary Stroke Prevention
This article reviews the evidence base and recommendations for medical management for secondary stroke prevention. RECENT FINDINGS Recent developments for secondary stroke prevention include evidence to support the use of short-term dual antiplatelet therapy after minor stroke and transient ischemic attack, direct oral anticoagulants for nonvalvular atrial fibrillation, reversal agents for direct oral anticoagulant–associated hemorrhage, and aspirin rather than presumptive anticoagulation with a direct oral anticoagulant for embolic stroke of undetermined source. SUMMARY Most strokes are preventable. The mainstays ...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Stroke Prevention: Little-Known and Neglected Aspects
Combining available therapies has the potential to reduce the risk of stroke by 80% or more. A comprehensive review of all aspects of stroke prevention would be very lengthy; in this narrative review, we focus on some aspects of stroke prevention that are little-known and/or neglected. These include the following: (1) implementation of a Mediterranean diet; (2) B vitamins to lower homocysteine; (3) coordinated approaches to smoking cessation; (4) intensive lipid-lowering therapy; (5) lipid lowering in the elderly; (6) physiologically individualized therapy for hypertension based on renin/aldosterone phenotyping; (7) avoidi...
Source: Cerebrovascular Diseases - May 27, 2021 Category: Neurology Source Type: research

Diabetes drug may prevent recurring strokes
Pioglitazone, a drug used for type 2 diabetes, may prevent recurrent stroke and heart attacks in people with insulin resistance but without diabetes. The results of the Insulin Resistance Intervention after Stroke (IRIS) trial, presented at the International Stroke Conference 2016 in Los Angeles and published in the New England Journal of Medicine, suggest a potential new method to prevent stroke and heart attack in high-risk patients who have already had one stroke or transient ischemic attack.
Source: NINDS Press Releases and News: National Institute of Neurological Disorders and Stroke - February 17, 2016 Category: Neurology Source Type: news

IRIS: Diabetes Drug Reduces Recurrent Stroke, MIIRIS: Diabetes Drug Reduces Recurrent Stroke, MI
A randomized trial shows that in patients with insulin resistance but no diabetes and a history of recent stroke or TIA, pioglitazone reduced recurrent stroke and myocardial infarction vs placebo. Medscape Medical News
Source: Medscape Neurology and Neurosurgery Headlines - February 17, 2016 Category: Neurology Tags: Neurology & Neurosurgery News Source Type: news

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

Insulin Resistance Intervention After Stroke Trial of Pioglitazone: Is This Perhaps the End of the Beginning? Emerging Therapy Critiques
Source: Stroke - June 26, 2016 Category: Neurology Authors: Ntaios, G., Kent, T. A. Tags: Diabetes, Type 2 Emerging Therapy Critiques Source Type: research

Potential New Horizons for the Prevention of Cerebrovascular Diseases and Dementia
In this issue ofJAMA Neurology, Spence et al discuss the effect of pioglitazone, an insulin-sensitizing agent that has been shown to reduce the risk of recurrent stroke and myocardial infarction in patients with insulin resistance, in patients with prediabetes. Prediabetes was defined according to the American Diabetes Association criteria, ie, a hemoglobin A1c level of 5.7% to 6.4% or a fasting plasma glucose level of 100 to 125 mg/dL. Data were taken from the Insulin Resistance Intervention after Stroke (IRIS) study, an international randomized clinical trial performed in patients with previous stroke or transient ischem...
Source: JAMA Neurology - February 7, 2019 Category: Neurology 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

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

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