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Campbell IW. Pioglitazone — an oral antidiabetic agent and metabolic syndrome modulator. Can theory translate into practice? ACTA ACUST UNITED AC 2016. [DOI: 10.1177/14746514050050040601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The metabolic syndrome, associated with insulin resistance, is a cluster of cardiovascular risk factors which results in premature morbidity and mortality from atherosclerotic vascular disease. Pioglitazone, a peroxisome-proliferator-activated receptor gamma (PPARγ) agonist, is an insulin sensitiser with the ability to address key features of the metabolic syndrome: glucose intolerance including type 2 diabetes, hypertension, dyslipidaemia, the pro-coagulant state, endothelial dysfunction, inflammation and atherosclerosis. The greatest potential benefit of pioglitazone is to influence atherogenesis itself through its pleiotrophic effects on vascular risk factors. This has been tested by the PROactive study, results of which are published in September 2005.
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Affiliation(s)
- Ian W Campbell
- Department, Victoria Hospital, Kirkcaldy, Fife KY2 5AH, Scotland, UK,
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Bottomley J, Palmer AJ, Williams R, Dormandy J, Massi-Benedetti M. Review: PROactive 03: Pioglitazone, type 2 diabetes and reducing macrovascular events — economic implications? ACTA ACUST UNITED AC 2016. [DOI: 10.1177/14746514060060020401] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
conomic value of medicines, medical devices and other technologies is an increasingly important consideration in healthcare management. Conducting high quality economic analyses alongside randomised controlled clinical trials (RCTs) is desirable since these offer timely information with high internal validity. The recent publication of the landmark PROactive study provides a relevant platform upon which to base a detailed economic evaluation of the possible additional benefit of pioglitazone over and above current best treatment in patients with type 2 diabetes with severe cardiovascular (CV) disease. Pioglitazone improved CV outcome and reduced the need to add insulin to existing therapy in individuals at high risk of further macrovascular events. The predefined economic analysis of this study using well-accepted methods will inform the cost effectiveness (CE) of pioglitazone confirming (or not) its value in the management of patients with type 2 diabetes with severe CV disease.
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Affiliation(s)
- Julia Bottomley
- Amygdala Ltd, The Warren, Willian Road, Letchworth Garden City, Hertfordshire, SG6 2AA, UK,
| | - Andrew J Palmer
- Amygdala Ltd, The Warren, Willian Road, Letchworth Garden City, Hertfordshire, SG6 2AA, UK
| | - Rhys Williams
- Amygdala Ltd, The Warren, Willian Road, Letchworth Garden City, Hertfordshire, SG6 2AA, UK
| | - John Dormandy
- Amygdala Ltd, The Warren, Willian Road, Letchworth Garden City, Hertfordshire, SG6 2AA, UK
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Eschwège E. Le syndrome métabolique : quelle(s) définition(s) pour quel(s) objectif(s) ? ANNALES D'ENDOCRINOLOGIE 2005. [DOI: 10.1016/s0003-4266(05)81732-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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