[Are pioglitazone and fenofibrate effective for the prevention of cardiovascular disease in type 2 diabetes?].
This year, two prospective randomized studies aimed at the reduction of composite cardiovascular endpoints in type 2 diabetic patients. The PROactive study estimated the impact of pioglitazone in the secondary prevention. The significant reduction of the primary composite endpoint was not obtained: reduction of the relative risk (RR) of 10 % (p= 0.095). However, the secondary composite endpoint was significantly reduced RR 16 % (p = 0.027). The FIELD study also had the same objectives. The primary composite endpoint was not significantly reduced in spite of a RR of 11% while the reduction of RR was significant for the secondary composite endpoint (p = 0.035). These studies reveal the difficulties and the complexity of the secondary prevention of atherosclerosis for patients already treated with effective molecules.
Ruiz
J
J
Service d'endocrinologie, diabétologie et métabolisme, Département de médecine interne, CHUV, IO11 Lausanne. juan.ruiz@chuv.ch
D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D011345:Fenofibrate / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D000077205:Pioglitazone; D016032:Randomized Controlled Trials as Topic; D045162:Thiazolidinediones / Q000627:therapeutic use*
D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D045162:Thiazolidinediones; D011345:Fenofibrate; D000077205:Pioglitazone