Showing posts with label Pioglitazone. Show all posts
Showing posts with label Pioglitazone. Show all posts

Tuesday, January 31, 2017

Clinical trial finds pioglitazone drug safe and effective for NASH patients

In continuation of my update on Pioglitazone


Researchers have found that an existing diabetes drug can be used to halt progression of another disease that is a leading cause of liver transplants.

A three-year clinical trial led by University of Florida Health researcher Kenneth Cusi, M.D., found that the drug pioglitazone is safe and effective in certain patients who have nonalcoholic steatohepatitis, or NASH, a chronic liver disease caused by a buildup of fat. The findings are published today (June 20) in the journal Annals of Internal Medicine.

NASH is often known as "silent" liver disease and affects 10 to 20 percent of the population and perhaps as many as one-third of all patients with adult-onset diabetes in the United States, according to recent studies. Left unchecked, NASH can cause chronic inflammation that leads to liver cancer or cirrhosis. NASH is now the second-leading cause of liver transplants and the numbers continue to grow each year, said Cusi, chief of the division of endocrinology, diabetes and metabolism in the UF College of Medicine's department of medicine.

Early diagnosis and treatment of NASH is crucial for those who are at greatest risk for the disease, usually obese patients who also have prediabetes or Type 2 diabetes. But until now, Cusi said, there was little urgency to diagnose NASH because there were no available medications.

The research group's single-center clinical trial involving 101 NASH patients with prediabetes or Type 2 diabetes found that pioglitazone reduced fatty liver disease activity in 58 percent of participants. In just more than half the participants -- 51 percent -- the disease was reduced enough that it was no longer considered a threat to the liver.

"The exciting thing is that there is a generic drug that already prevents the onset of Type 2 diabetes and cardiovascular disease in recent studies. Now, it can reduce disease from excess liver fat accumulation and liver inflammation, and halt fibrosis that leads to cirrhosis. This will have a lot of long-term benefits for many people with a medication that will be very affordable and is already being used to treat Type 2 diabetes," Cusi said.

The study also has implications for people with prediabetes and NASH because fatty liver disease is a risk factor for Type 2 diabetes even in those who aren't obese, researchers said.
Federal regulators approved Actos (pioglitazone) in 2000 and a generic version of the drug in 2012 to improve blood glucose control in adults with Type 2 diabetes. Still, pioglitazone's use against liver disease will require a larger, multicenter clinical trial that could take seven years or more in addition to U.S. Food and Drug Administration approval. A multicenter trial would allow researchers to learn more about the drug's long-term benefits for liver issues and determine why some participants respond better than others to the medication, Cusi said.

Researchers aren't entirely certain about how pioglitazone works against liver disease. Patients with NASH are insulin-resistant, meaning their body does not respond normally to their own insulin. This defect promotes fat accumulation and inflammation in the liver. The researchers believe the medication makes molecular improvements in the liver and other tissues such as fat. That helps the body's response to insulin, making it insulin-sensitive again and restoring normal metabolism.

Despite the recent trial's relatively small size, Cusi noted that it's the largest single-center study and the first long-term study examining the drug as treatment for people who have NASH along with prediabetes or Type 2 diabetes. It is also the longest NASH-related study with any drug and had the greatest treatment effect on NASH compared with other approaches, he said.

Tuesday, June 18, 2013

Diabetes drug shows promise in treatment of neurodegenerative disease

In continuation of my update on Pioglitazone

We know thatPioglitazone is a prescription drug of the class thiazolidinedione (TZD) with hypoglycemic (antihyperglycemic, antidiabetic) action to treat diabetes. It is used to improve glucose control in adults over the age of 18 with type 2 diabetes. Pioglitazone is marketed as trademarks Actos in the USA, Canada, the UK and Germany, Glustin in Europe, Glizone and Pioz in India by Zydus Cadila and USV Limited, respectively and Zactos in Mexico by Takeda Pharmaceuticals....

Now Researchers in Spain have found that a drug used to control Type II diabetes can help repair the spinal cords of mice suffering from the inherited disease adrenoleukodystrophy which, untreated, leads eventually to a paralysis, a vegetative state and death. They believe that their findings may be relevant to other neurodegenerative diseases. A Phase II trial will be starting shortly. ...

Monday, June 11, 2012

Lilly, Boehringer Ingelheim announce results from linagliptin Phase III trial on T2D

 In continuation of my update on Linagliptin

Results of the one Phase III study presented (Poster No. 999-P) showed that linagliptin was effective as an add-on therapy to basal insulin alone or in combination with metformin and/or pioglitazone in reducing blood glucose levels in adult patients with T2D, when compared to placebo as an add-on to these background therapies. Linagliptin demonstrated a placebo-adjusted reduction in HbA1c of 0.65% (p<0.0001) from a baseline HbA1c of 8.3% at 24 weeks without weight gain or additional risk of hypoglycaemia.  HbA1c is measured in people with diabetes to provide an index of blood glucose control for the previous two to three months. 

A post-hoc analysis from a second Phase III trial (Poster No. 1044-P) found that in hyperglycaemic patients on a background of metformin randomised to add linagliptin or glimepiride, a greater proportion of patients taking linagliptin achieved target HbA1c <7% without weight gain and/or hypoglycaemia than those taking glimepiride after 104 weeks (linagliptin 54% versus glimepiride 23%) while comparably improving blood glucose levels.

Monday, December 13, 2010

Pioglitazone, may halt the growth of cysts in Polycystic Kidney Disease....

Recently, researchers from the schools of Science and Medicine at Indiana University-Purdue University Indianapolis and colleagues from the Mayo Clinic reported that drug Pioglitazone, (see structure Enantiomers) commonly used to treat diabetes may also retard the growth of fluid-filled cysts of the most common genetic disorder, polycystic kidney disease.

Using a rat model that has the same genetic mutation as a form of human PKD, the two research groups independently tested a pioglitazone treatment regimen and found that it slowed down both kidney and liver cyst growth by inhibiting a chloride channel in the cells of these organs. Authors claim that the, though the idea of using a chloride channel inhibitor to treat PKD is not new, but usage of an insulin sensitizing agent like piogltiazone inhibits chloride channels is new. The finding that pioglitazone, which has already been approved by the Food and Drug Administration for diabetes, can halt cyst progression and may be an effective and well-tolerated treatment for this chronic disease, is exciting. Confirmation of these results in other animal models of PKD would be a useful next step.....

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