Schernthaner Guntram
Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria.
Drugs Today (Barc). 2006 Dec;42 Suppl C:17-23.
The placebo-controlled Prospective Pioglitazone Clinical Trial in Macrovascular Events (PROactive) is the only study of secondary prevention in patients with type 2 diabetes to have shown a benefit. While treatment with pioglitazone did not significantly reduce the primary composite endpoint, it did significantly lower the incidence of many of its components, including all-cause mortality, nonfatal myocardial infarction (including silent infarctions), stroke, acute coronary syndrome and limb amputation. Pioglitazone also reduced the relative risk of the combined endpoint of death, myocardial infarction and stroke by 16% compared to placebo. In the subgroup of patients with myocardial infarction, the risk of myocardial infarction and acute coronary syndromes was reduced with the active treatment, which also substantially reduced (-47%) the risk of stroke in patients with prior stroke. Pioglitazone has furthermore demonstrated numerous antiatherogenic effects in clinical and preclinical investigations.
安慰剂对照的吡格列酮大血管事件前瞻性临床试验（PROactive）是唯一一项显示对2型糖尿病患者二级预防有益的研究。虽然吡格列酮治疗未显著降低主要复合终点，但确实显著降低了其许多组分的发生率，包括全因死亡率、非致命性心肌梗死（包括无症状梗死）、中风、急性冠状动脉综合征和肢体截肢。与安慰剂相比，吡格列酮还使死亡、心肌梗死和中风的联合终点相对风险降低了16%。在心肌梗死患者亚组中，活性治疗降低了心肌梗死和急性冠状动脉综合征的风险，同时也大幅降低（-47%）了既往有中风患者的中风风险。此外，吡格列酮在临床和临床前研究中已显示出多种抗动脉粥样硬化作用。
