Kernan and colleagues randomly assigned nearly 4,000 patients who had suffered a stroke or a mini-stroke to Actos and a placebo. None of the patients had diabetes but they did have evidence of insulin resistance, putting them at risk for the blood-sugar disease.
Over nearly five years of follow-up, 9 percent of those taking Actos had another stroke or heart attack, compared with nearly 12 percent of those receiving placebo, the researchers found.
Nearly 4 percent of those taking Actos developed diabetes, compared with nearly 8 percent of those taking the placebo, the study showed.According to Kernan, no one knows how Actos works to prevent stroke, but the best guess is that the drug reduces inflammation, improves insulin resistance, helps manage fats in the body and "favorably affects the function of blood vessels. This provides a fairly strong evidence that insulin resistance is an important new target for prevention of stroke, according to him and takes preventive neurology in a new direction and opens up new opportunities for the care of patients. Dr. Richard Libman, vice chairman of neurology at Long Island Jewish Medical Center in New Hyde Park, N.Y said this new finding may add to the ability to prevent recurrent strokes, but it needs to be confirmed before the drug can be widely used. Also Dr. Gerald Bernstein, endocrinologist at the Friedman Diabetes Institute of Lenox Hill Hospital in New York City acknowledged that this is a straightforward look at a few thousand people over a reasonable period showing the benefits and liabilities of Actos, the question we are left with is whether we have something that is all upside and no downside.
Source: About MedlinePlus
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