Recently I’ve read: M.J. Ormseth and colleagues: “Peroxisome
proliferator-activated receptor gamma agonist effect on rheumatoid arthritis: a
randomized controlled trial.” (Arthritis Res Ther. 2013 Sep
10;15(5):R110. [Epub ahead of print] / http://www.ncbi.nlm.nih.gov/pubmed/24020899).
Methods: “In a single center, randomized, double-blind, placebo-controlled,
cross-over study patients with RA (n = 34) receiving stable therapy were
randomized to also receive either pioglitazone 45 mg daily (n = 17) or matching
placebo (n = 17) for 8 weeks.” I haven’t seen a primary endpoint. The
conclusion: “Addition of pioglitazone to RA therapy improves insulin resistance
and modestly reduces RA disease activity measured by DAS28 CRP and two of its
components including patient-reported global health, and CRP; but not DAS28 ESR
or ESR.”
I’ve already written on the subject: http://rheumatologe.blogspot.de/2012/12/pioglitazone-at-acr-2012-in-washington.html.
Now, I’ve reread the abstract the same authors published in
2012. Methods: “In a single center, randomized, double blind, placebocontrolled
cross-over trial of 20 weeks duration, patients with RA (n_34) and moderate disease
activity receiving stable disease modifying anti-rheumatic drug therapy were
randomized to receive either pioglitazone 45mg daily (n_17) or matchingplacebo
(n_17) for 8 weeks in addition to current therapy.“ And the conclusion: “The
addition of pioglitazone to current RA treatment improves insulin resistance
and modestly reduces RA disease activity measured by DAS28 CRP and CRP levels.”
So, we don’t have a new study and repeating an old study
doesn’t make it more convincing.
I’d like to quote myself:
“Addendum 06.03.2013:
France had withdrawn the approval of pioglitazone because of
the increased incidence of bladder cancer. Another problem is the increase of
bone loss. This might reduce even more the handiness in treating patients who
are already at a risk for bone loss. http://informahealthcare.com/doi/abs/10.1517/14740331003623218
I'll keep it on my list, though I think that Takeda is
looking for a new playground for pioglitazone.”
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