Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms
Am Fam Physician. 2016 Aug 15;94(4):319.
In patients with evidence of insulin resistance and a recent stroke or transient ischemic attack (TIA), does pioglitazone (Actos) improve outcomes?
In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm [NNTH] =14), edema (NNTH = 9), and fracture (NNTH = 53). The risk of receiving a diagnosis of diabetes mellitus is lowered, but that is predictable when you give someone a medicine that lowers blood sugar. (Level of Evidence = 1b)
The researchers in this trial hypothesized that because
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