November - 24 - 2009
Pioglitazone hydrochloride, an orally active insulin sensitizer, was reported to significantly reduce the levels of natural killer (NK) cells and decrease the expression of chemokine receptor (CCR) 2 on circulating CD14+ cells in type 2 diabetes patients with zotarolimus-eluting stent (ZES) implantation in a study presented at the 2009 American Heart Association's Scientific Sessions held in Orlando. Patients with type 2 diabetes and significant coronary artery stenosis were randomized to receive treatment with pioglitazone hydrochloride or placebo (n = 47/group) following ZES implantation. Intravascular ultrasonography evaluation performed at baseline and at 8 months of treatment revealed significantly lower atherosclerosis progression in the pioglitazone hydrochloride-treated group compared to the placebo group at segments both proximal (P = 0.035) and distal (P = 0.023) to the stent. Treatment with pioglitazone hydrochloride correlated with a significantly lower neointima volume compared to placebo (P <0.001). Monitoring of changes in NK cells and in inflammatory markers showed a significant reduction in NK cells at 2 days post-stenting in the pioglitazone hydrochloride group (P = 0.008 vs. placebo) and a 29% decrease from baseline in CCR2 expression on CD14+ cells at the same time point. In the placebo group, CCR2 expression exhibited a 50% increase at 2 days after stenting. The study supports additional evaluation of pioglitazone hydrochloride for the treatment of type 2 diabetes (Hong, S.J. et al. Circulation [Am Heart Assoc Sci Sess (Nov 14.18, Orlando) 2009] 2009, 120(18, Suppl): Abst 979).