The diabetes drug pioglitazone (brand name Actos) has been linked to health benefits as well as risks according to the authors of a review which examined 22 studies of the drug involving 6,200 type 2 diabetes patients.
Lead author Dr. Bernd Richter said 'Our results showed that published scientific studies of at least 24 weeks of pioglitazone treatment in people with type 2 diabetes mellitus did not provide convincing evidence that patient-oriented outcomes like mortality, morbidity, adverse effects and health-related quality of life are positively influenced by this drug.'
His review was not only unable to identify any definite benefit from taking pioglitazone, but in addition the researchers also found that patients taking this drug appeared to have increased rates of edema and heart failure.
The researchers also concluded that taking pioglitazone in combination with the sulfonylureas such as tolbutamide, glipizide and glimepiride may cause dangerous drops in blood glucose.
Richter, an assistant professor in the department of endocrinology, diabetes and rheumatology at Heinrich Heine University in Germany said, "Until new evidence becomes available, the benefit-risk ratio of pioglitazone therapy in type 2 diabetes mellitus remains unclear."
According to Richter pioglitazone treatment should be restricted to patients showing real benefits like fewer diabetic complications and improved health-related quality of life from taking the drug. These findings have been published in the current issue of The Cochrane Library journal.
Pioglitazone belongs to the family of thiazolidinediones drugs which are designed to increase the body's sensitivity to naturally produced insulin to foster better uptake of glucose into cells and lower blood-glucose levels.
Dr. John Buse, director of the Diabetes Care Center at the University of North Carolina School of Medicine at Chapel Hill, said, "The kernel from this review is that pioglitazone is effective in glucose-lowering, has some other beneficial and potentially harmful associated features, and just has not been evaluated in the right way to prove that it will help people lead longer and more productive lives."
Buse added, "This is true for essentially every drug available for the treatment of diabetes."