Diabetes Drug Prevents Stroke Recurrence In Some Patients

Pioglitazone use helps prevent ischemic stroke recurrence in patients with ischemic stroke and insulin resistance, but not diabetes, a recent study showed.

Using data from the Insulin Resistance Intervention after Stroke (IRIS) trial, the researchers assessed stroke outcomes among 3876 patients (mean age 63 years) who had been randomly assigned to treatment with 45 mg pioglitazone once daily or placebo.
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Follow-up lasted a median of 4.8 years and a maximum of 5 years. All potential stroke outcomes were adjudicated by an independent committee.

Results indicated that 377 stroke events had occurred in 319 participants over the course of follow-up. The researchers found that pioglitazone use was associated with a 25% lower risk for any stroke (8.0% vs 10.7%; hazard ratio [HR] 0.75) and a 28% lower risk for ischemic stroke (HR 0.72). However, this association was not observed for hemorrhagic stroke (HR 1.00).

Pioglitazone was also associated with reduced rates of all subtypes of ischemic stroke. However, this was only statistically significant for lacunar (HR 0.46) and large vessel (HR 0.59) strokes.

“Pioglitazone prevents recurrent ischemic stroke among non-diabetic patients with insulin resistance,” the researchers concluded.

—Christina Vogt

Reference:

Yaghi S, Furie K, Viscoli CM, et al. Pioglitazone prevents stroke in patients with a recent TIA or ischemic stroke: a secondary analysis of the IRIS trial. Paper presented at: International Stroke Conference; January 24-26, 2018; Los Angeles, CA. http://stroke.ahajournals.org/content/49/Suppl_1/A101.