Diabetes drugs for preventing recurrent stroke and other blo | Figure 1

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Diabetes drugs for preventing recurrent stroke and other blood vessel disease

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Diabetes drugs for preventing stroke and other blood vessel disease in people who have had a previous stroke or transient ischaemic attack

Question

We wanted to evaluate the effectiveness and safety of new diabetes drugs (peroxisome proliferator‐activated receptor gamma (PPAR‐γ) agonists) in the prevention of stroke and related blood vessel disease in people who have already had a stroke or transient ischaemic attack.

Background

Peroxisome proliferator‐activated receptor gamma agonists are drugs that improve the way insulin works in the human body. They are widely used in the treatment of adult type diabetes (type 2 diabetes). Moreover, they may also protect against the presence of excess fats in the blood and disease of the artery walls, which are both risk factors for stroke.

Study characteristics

We identified five studies to 30 July 2019 including a total of 5039 participants. Four studies evaluated the drug pioglitazone, and one study evaluated rosiglitazone. Four studies included participants who had no history of diabetes, and one study included only participants with diabetes.

Key results

Compared with placebo tablets, PPAR‐γ agonists reduced recurrent strokes and other blood vessel disease, improved the body's response to insulin, and stabilised fatty deposits in artery walls. The drugs also appeared to be well tolerated, but the evidence for this was inconclusive.

Quality of the evidence

Our conclusions should be interpreted with caution considering the small number of included studies and the limited quality of some of the studies. Further well‐designed randomised controlled trials with large sample sizes are required.

Read the full Cochrane Review here

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