Targeting Pioglitazone for Greatest Benefit in Stroke Patients

Consider adding pioglitazone in the face of insulin resistance after stroke.

In a trial published last year (NEJM JW Neurol Apr 2016 and N Engl J Med 2016; 374:1321), the insulin sensitizer pioglitazone reduced the risk for stroke or myocardial infarction (MI) in patients who had had an ischemic stroke or transient ischemic attack in the prior 180 days. Pioglitazone was compared with placebo and administered along with other secondary preventives, such as antiplatelet medications and statins. Pioglitazone was associated with an increase in bone fractures and weight gain.

In a secondary analysis, the same authors attempted to determine whether pioglitazone benefits patients at high risk for recurrent stroke or MI. Six features were used to characterize the high-risk group: aphasia, coronary artery disease, hypertensio…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Targeting Pioglitazone for Greatest Benefit in Stroke Patients

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Reviewing Author