Takeda’s Actos(R)
reduced heart attacks In people with Type 2 Diabetes
Newswise — New results
from secondary analyses of the landmark PROactive Study
found that ACTOS® (pioglitazone HCl) significantly reduced
the occurrence of fatal and non-fatal heart attacks and
acute coronary syndrome (ACS) in high-risk patients with
type 2 diabetes who had a previous heart attack.
Importantly, these results were above and beyond those seen
with standard of care treatment.
The findings, which were
revealed today at the American Heart Association’s
Scientific Sessions 2005, build on previously-reported
results from the PROactive Study, showing that ACTOS, an
oral antidiabetic medication, significantly reduced the
combined risk of heart attacks, strokes and death by 16
percent in high-risk patients with type 2 diabetes.
“Takeda is breaking new
ground with the PROactive Study. Never before have this many
high-risk people with type 2 diabetes and cardiovascular
disease been studied,” said Robert Spanheimer, M.D., medical
director for diabetes and metabolism at Takeda
Pharmaceuticals North America. “Through this innovative
research, we now know that ACTOS can markedly reduce the
recurrence of heart attacks.”
These data assessed the
effects of ACTOS on cardiovascular morbidity and mortality
in 2,445 high-risk patients who had previously had a heart
attack, a population that tends to have a very poor
prognosis. The results show that in patients taking ACTOS on
top of standard of care treatment:
• The recurrence of fatal
or non-fatal heart attacks was reduced by 28 percent (P
=0.045)
• The risk of acute
coronary syndrome or ACS (a term used to describe
potentially life-threatening, acute cardiovascular events)
was reduced by 37 percent (P =0.035)
• There was a 19 percent
(P=0.034) risk reduction in the cardiac composite endpoint
of non-fatal heart attacks, coronary revascularization, ACS
and cardiac death
“These results are very
meaningful for the diabetes community, especially when you
consider that people with type 2 diabetes are more likely
than those without diabetes to die from a heart attack and
to have a second event,” continued Dr. Spanheimer. “ACTOS is
a type 2 diabetes medication that has now been shown to
reduce the recurrence of heart attacks. Until we know how
ACTOS works to provide this life-saving benefit, the results
of PROactive should not be generalized to any other
glucose-lowering medication.”
About the PROactive Study
PROactive (PROspective
PioglitAzone Clinical Trial In MacroVascular Events) was the
first study to prospectively look at the reduction in total
mortality and macrovascular morbidity using a
glucose-lowering agent. It was a randomized, double blind,
placebo-controlled outcome study of 5,238 patients with type
2 diabetes and macrovascular disease. Patients were
randomized to receive either ACTOS or placebo in addition to
other blood-glucose medications and on top of standard of
care treatment (including the routine use of anti-hypertensives
such as ACE inhibitors and beta blockers; glucose-lowering
agents such as metformin, sulfonylureas and insulin;
antiplatelet drugs such as aspirin, and lipid-modifying
medicines such as statins and fibrates).
This study focused on two
key endpoints: a primary combination endpoint of seven
different macrovascular events of varying clinical
importance; and a principal secondary combination endpoint
of life-threatening events including death, heart attack and
stroke.
As reported at the
European Association for the Study of Diabetes (EASD) Annual
Meeting in September 2005, the primary endpoint was reduced
by 10 percent but had not reached statistical significance
by study end (P =0.095). The principal secondary endpoint of
life-threatening events showed that ACTOS significantly
reduced the risk of heart attacks, strokes and death by 16
percent (P =0.027).
ACTOS, an insulin
sensitizer belonging to the thiazolidinedione (TZD) class of
oral anti-diabetic medications, directly targets insulin
resistance, a condition in which the body does not
efficiently use the insulin it produces to control blood
glucose levels. ACTOS is taken once daily as an adjunct to
diet and exercise, and is approved for use in type 2
diabetes as monotherapy to lower blood glucose and in
combination therapy with insulin, sulfonylureas or metformin.