Abstract

Pioglitazone: lessons and learnings 15 years since launch and beyond

Author(s): Oded Stempa

Pioglitazone is a PPARγ agonist that is widely used as an oral antihyperglycemic agent. Its main effect consists of blunting insulin resistance in tissues such as muscle, liver and adipose tissue. Its strength in terms of glycosylated hemoglobin AIc reduction varies within a range of -1.0 to -1.5%. This article examines the role of pioglitazone in the treatment of Type 2 diabetes mellitus and assesses efficacy data on insulin sensitivity and glycemic control, as well as the effects on hepatic steatosis, endothelial function and cardiovascular risk. Finally, concerns linked to pioglitazone use, such as weight gain, fluid retention, bone fragility, bladder cancer and macular edema, are analyzed finding that pioglitazone use must be balanced between the risks and benefits for each individual patient.