Pioglitazone May Reduce Cardiovascular, Noncardiovascular Mortality in T2D

White pills in blister pack
White pills in blister pack
An exploratory extension analysis using data from a large cohort reexamines whether pioglitazone use is associated with decreases in all-cause and cardiovascular-specific mortality.

Pioglitazone use may be associated with a decrease in both cardiovascular and noncardiovascular mortality for patients with type 2 diabetes (T2D), according to results of an extended database cohort analysis published in BMJ Open Diabetes Research and Care.

The results suggest that these broader benefits of pioglitazone support its safe and effective use for patients with T2D.

The exploratory linked database cohort analysis pooled health and mortality data from Finland, Sweden, and the United Kingdom. The study included participants with T2D who were first prescribed pioglitazone from 2000 to 2011 (n=31,133) and matched control patients with T2D who had never been prescribed pioglitazone (n=31,133). Participants were matched for treatment stage, history of diabetes, diabetes complications, cardiovascular disease, and year of cohort entry. Mean follow-up time was 2.60 and 2.69 years in the pioglitazone and control groups, respectively.

The researchers found that the pioglitazone group had a lower cardiovascular-related and noncardiovascular-related mortality compared with the control group (adjusted hazard ratio, 0.58 [95% CI, 0.52-0.63] and 0.63 [95% CI, 0.58-0.68], respectively).

Participants in the pioglitazone group had significantly reduced risk for several cause-specific mortalities compared with control patients. The pioglitazone group had a 39% reduction for myocardial infarction-related mortality, 52% reduction for stroke-related mortality, and 40% for heart failure-related mortality compared with control patients.

Related Articles

The researchers stressed that this was an exploratory study and suggest further studies that test the association between pioglitazone use and patient-focused outcomes.


Pasi Korhonen, Fabian Hoti, Solomon Christopher, and Maila Majak are employed by EPID Research; Edith M. Heintjes is employed by PHARMO Institute; Rachael Williams and Helen Strongman are employed by CPRD; and Marie Linder and Shahram Bahmanyar are employed by Karolinska Institute. EPID Research, PHARMO Institute, CPRD and the Centre for Pharmacoepidemiology at Karolinska Institute perform commissioned pharmacoepidemiological studies, and thus their employees have been and currently are working in collaboration with several pharmaceutical companies (including Takeda). Dimitri Bennett is employed by Takeda Pharmaceutical Company Limited.


Strongman H, Christopher S, Majak M, et al Pioglitazone and cause-specific risk of mortality in patients with type 2 diabetes: extended analysis from a European multidatabase cohort study. BMJ Open Diabetes Res Care. 2018;6:e000481.