Pioglitazon
Pioglitazon
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Actos, Competact, Pioglitazon Orion, Pioglitazone Accord, Pioglitazone......
Actos, Competact, Pioglitazon Orion, Pioglitazone Accord, Pioglitazone Actavis, Pioglitazone Teva PharmaATC-koder
A10BD05, A10BG03
A10BD05, A10BG03Substanser
pioglitazon, pioglitazonhydroklorid
pioglitazon, pioglitazonhydrokloridSammanfattning
Hos både kvinnor och män med diabetes som behandlats med pioglitazon i kombination med insulin är risken att dö lägre jämfört med patienter som endast insulinbehandlats. Vissa studier har visat en ökad frakturrisk framförallt hos kvinnor men även hos män behandlade med pioglitazon. Män som behandlas med pioglitazon verkar ha en ökad risk för att utveckla blåscancer.
Hos både kvinnor och män med diabetes som behandlats med pioglitazon i kombination med insulin är risken att dö lägre jämfört med patienter som endast insulinbehandlats. Vissa studier har visat en ökad frakturrisk framförallt hos kvinnor men även hos män behandlade med pioglitazon. Män som behandlas med pioglitazon verkar ha en ökad risk för att utveckla blåscancer.Background
Studies indicate that men in the early middle age have a higher prevalence of type 2 diabetes mellitus compared with women in the same age group [1]. In Sweden, the age-standardized prevalence of pharmacologically and non-pharmacologically treated diabetes was 56% for men and 39% for women in 2012 [2]. Visa hela bakgrundstexten
According to the original manufacturer, the mean Cmax and AUC values of pioglitazone is increased 20-60% in women compared to men. HbA1c decreases from baseline were generally greater for women than for men [3,4]. However, other studies (one study 61 men, 63 women, the other 18 men, 19 women) report only small or non-significant sex differences in Cmax and AUC [5, 6].
Some studies report sex differences in pioglitazone pharmacokinetics [3, 5], and the dose should be individualized for each patient. However, no dose adjustment is necessary only based on a patient’s sex. High pioglitazone doses are associated with greater risk of fracture in women aged 50 years and older [7].
Effects
A meta-analysis examining factors associated with reduction in HbA1c from rosiglitazone and pioglitazon......
Försäljning på recept
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Fler män än kvinnor hämtade ut tabletter innehållande pioglitazon (ATC-kod A10BG03) på recept i Sverige år 2020, totalt 3 303 män och 1 880 kvinnor. Det motsvarar 0,6 respektive 0,4 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 70-79 år hos båda könen. I genomsnitt var tabletter innehållande pioglitazon 1,6 gånger vanligare hos män [28]. Något fler män än kvinnor hämtade ut tabletter innehållande kombination av metformin och pioglitazon (ATC-kod A10BD05) på recept i Sverige år 2020, totalt 46 män och 18 kvinnor [28].
Referenser
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Gale EA, Gillespie KM. Diabetes and gender. Diabetologia. 2001;44(1):3-15.
Jansson SP, Fall K, Brus O, Magnuson A, Wändell P, Östgren CJ et al. Prevalence and incidence of diabetes mellitus: a nationwide population-based pharmaco-epidemiological study in Sweden. Diabet Med. 2015;32(10):1319-28.
DailyMed Actos (pioglitazone). DailyMed [www]. US National Library of Medicine. [updated 2021-01-13, cited 2021-07-15].
Pioglitazone pharmacokinetics. Drugs.com [www]. [updated 2021-06-21, cited 2021-07-15].
Karim A, Slater M, Bradford D, Schwartz L, Zhao Z, Cao C et al. Oral antidiabetic drugs: bioavailability assessment of fixed-dose combination tablets of pioglitazone and metformin Effect of body weight, gender, and race on systemic exposures of each drug. J Clin Pharmacol. 2007;47:37-47.
Karim A, Zhao Z, Slater M, Bradford D, Schuster J, Laurent A. Replicate study design in bioequivalency assessment, pros and cons: bioavailabilities of the antidiabetic drugs pioglitazone and glimepiride present in a fixed-dose combination formulation. J Clin Pharmacol. 2007;47:806-16.
Bilik D, McEwen LN, Brown MB, Pomeroy NE, Kim C, Asao K et al. Thiazolidinediones and fractures: evidence from translating research into action for diabetes. J Clin Endocrinol Metab. 2010;95:4560-5.
Phatak HM, Yin DD. Factors associated with the effect-size of thiazolidinedione (TZD) therapy on HbA(1c): a meta-analysis of published randomized clinical trials. Curr Med Res Opin. 2006;22:2267-78.
Tajiri Y, Takei R, Mimura K, Umeda F. Indicators for the efficacy of pioglitazone before and during treatment in Japanese patients with type 2 diabetes. Diabetes Technol Ther. 2007;9:429-37.
Yen FS, Wang HC, Pan CW, Wei JC, Hsu CC, Hwu CM. Pioglitazone Exposure Reduced the Risk of All-Cause Mortality in Insulin-Treated Patients with Type 2 Diabetes Mellitus. J Clin Endocrinol Metab. 2020;105(2).
Lecka-Czernik B. Bone loss in diabetes: use of antidiabetic thiazolidinediones and secondary osteoporosis. Curr Osteoporos Rep. 2010;8:178-84.
Loke YK, Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009;180:32-9.
Aubert RE, Herrera V, Chen W, Haffner SM, Pendergrass M. Rosiglitazone and pioglitazone increase fracture risk in women and men with type 2 diabetes. Diabetes Obes Metab. 2010;12:716-21.
Habib ZA, Havstad SL, Wells K, Divine G, Pladevall M, Williams LK. Thiazolidinedione use and the longitudinal risk of fractures in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2010;95:592-600.
Meier C, Kraenzlin ME, Bodmer M, Jick SS, Jick H, Meier CR. Use of thiazolidinediones and fracture risk. Arch Intern Med. 2008;168:820-5.
Douglas IJ, Evans SJ, Pocock S, Smeeth L. The risk of fractures associated with thiazolidinediones: a self-controlled case-series study. PLoS Med. 2009;6:e1000154.
Jonas D, Van Scoyoc E, Gerrald K, Wines R, Amick H, Triplette M, Runge T. Drug Class Review: Newer Diabetes Medications, TZDs, and Combinations: Final Original Report . Oregon Health & Science University.
Dormuth CR, Carney G, Carleton B, Bassett K, Wright JM. Thiazolidinediones and fractures in men and women. Arch Intern Med. 2009;169:1395-402.
Pavlova V, Filipova E, Uzunova K, Kalinov K, Vekov T. Pioglitazone Therapy and Fractures: Systematic Review and Meta- Analysis. Endocr Metab Immune Disord Drug Targets. 2018;18(5):502-507.
Viscoli CM, Inzucchi SE, Young LH, Insogna KL, Conwit R, Furie KL et al. Pioglitazone and Risk for Bone Fracture: Safety Data From a Randomized Clinical Trial. J Clin Endocrinol Metab. 2017;102(3):914-922.
He S, Tang YH, Zhao G, Yang X, Wang D, Zhang Y. Pioglitazone prescription increases risk of bladder cancer in patients with type 2 diabetes: an updated meta-analysis. Tumour Biol. 2014;35:2095-102.
Bhushan S, Ray RS, Prakash J, Singh GN. Global Versus Indian Perspective of Pioglitazone-induced Adverse Drug Reactions Including Bladder Cancer: A Comparative Retrospective Pharmacovigilance Analysis. Clin Ther. 2019;41(11):2252-2262.
Niu SW, Chang KT, Lin HY, Kuo IC, Chang YH, Chen YH, Hung CC, Chiu YW, Hwang SJ. Decreased incidence of gout in diabetic patients using pioglitazone. Rheumatology (Oxford). 2018;57(1):92-99.
Wu HF, Kao LT, Shih JH, Kao HH, Chou YC, Li IH et al. Pioglitazone use and Parkinson's disease: a retrospective cohort study in Taiwan. BMJ Open. 2018;8(8):e023302.
Shea MK, Nicklas BJ, Marsh AP, Houston DK, Miller GD, Isom S et al. The effect of pioglitazone and resistance training on body composition in older men and women undergoing hypocaloric weight loss. Obesity (Silver Spring). 2011;19:1636-46.
Arnetz L, Dorkhan M, Alvarsson M, Brismar K, Ekberg NR. Gender differences in non-glycemic responses to improved insulin sensitivity by pioglitazone treatment in patients with type 2 diabetes. Acta Diabetol. 2014;51(2):185-92.
Esteghamati A, Noshad S, Rabizadeh S, Ghavami M, Zandieh A, Nakhjavani M. Comparative effects of metformin and pioglitazone on omentin and leptin concentrations in patients with newly diagnosed diabetes: a randomized clinical trial. Regul Pept. 2013;182:1-6.
Statistikdatabas för läkemedel. Stockholm: Socialstyrelsen. 2020 [cited 2021-03-10.]
- Gale EA, Gillespie KM. Diabetes and gender. Diabetologia. 2001;44(1):3-15.
- Jansson SP, Fall K, Brus O, Magnuson A, Wändell P, Östgren CJ et al. Prevalence and incidence of diabetes mellitus: a nationwide population-based pharmaco-epidemiological study in Sweden. Diabet Med. 2015;32(10):1319-28.
- DailyMed Actos (pioglitazone). DailyMed [www]. US National Library of Medicine. [updated 2021-01-13, cited 2021-07-15].
- Pioglitazone pharmacokinetics. Drugs.com [www]. [updated 2021-06-21, cited 2021-07-15].
- Karim A, Slater M, Bradford D, Schwartz L, Zhao Z, Cao C et al. Oral antidiabetic drugs: bioavailability assessment of fixed-dose combination tablets of pioglitazone and metformin Effect of body weight, gender, and race on systemic exposures of each drug. J Clin Pharmacol. 2007;47:37-47.
- Karim A, Zhao Z, Slater M, Bradford D, Schuster J, Laurent A. Replicate study design in bioequivalency assessment, pros and cons: bioavailabilities of the antidiabetic drugs pioglitazone and glimepiride present in a fixed-dose combination formulation. J Clin Pharmacol. 2007;47:806-16.
- Bilik D, McEwen LN, Brown MB, Pomeroy NE, Kim C, Asao K et al. Thiazolidinediones and fractures: evidence from translating research into action for diabetes. J Clin Endocrinol Metab. 2010;95:4560-5.
- Phatak HM, Yin DD. Factors associated with the effect-size of thiazolidinedione (TZD) therapy on HbA(1c): a meta-analysis of published randomized clinical trials. Curr Med Res Opin. 2006;22:2267-78.
- Tajiri Y, Takei R, Mimura K, Umeda F. Indicators for the efficacy of pioglitazone before and during treatment in Japanese patients with type 2 diabetes. Diabetes Technol Ther. 2007;9:429-37.
- Yen FS, Wang HC, Pan CW, Wei JC, Hsu CC, Hwu CM. Pioglitazone Exposure Reduced the Risk of All-Cause Mortality in Insulin-Treated Patients with Type 2 Diabetes Mellitus. J Clin Endocrinol Metab. 2020;105(2).
- Lecka-Czernik B. Bone loss in diabetes: use of antidiabetic thiazolidinediones and secondary osteoporosis. Curr Osteoporos Rep. 2010;8:178-84.
- Loke YK, Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009;180:32-9.
- Aubert RE, Herrera V, Chen W, Haffner SM, Pendergrass M. Rosiglitazone and pioglitazone increase fracture risk in women and men with type 2 diabetes. Diabetes Obes Metab. 2010;12:716-21.
- Habib ZA, Havstad SL, Wells K, Divine G, Pladevall M, Williams LK. Thiazolidinedione use and the longitudinal risk of fractures in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2010;95:592-600.
- Meier C, Kraenzlin ME, Bodmer M, Jick SS, Jick H, Meier CR. Use of thiazolidinediones and fracture risk. Arch Intern Med. 2008;168:820-5.
- Douglas IJ, Evans SJ, Pocock S, Smeeth L. The risk of fractures associated with thiazolidinediones: a self-controlled case-series study. PLoS Med. 2009;6:e1000154.
- Jonas D, Van Scoyoc E, Gerrald K, Wines R, Amick H, Triplette M, Runge T. Drug Class Review: Newer Diabetes Medications, TZDs, and Combinations: Final Original Report . Oregon Health & Science University.
- Dormuth CR, Carney G, Carleton B, Bassett K, Wright JM. Thiazolidinediones and fractures in men and women. Arch Intern Med. 2009;169:1395-402.
- Pavlova V, Filipova E, Uzunova K, Kalinov K, Vekov T. Pioglitazone Therapy and Fractures: Systematic Review and Meta- Analysis. Endocr Metab Immune Disord Drug Targets. 2018;18(5):502-507.
- Viscoli CM, Inzucchi SE, Young LH, Insogna KL, Conwit R, Furie KL et al. Pioglitazone and Risk for Bone Fracture: Safety Data From a Randomized Clinical Trial. J Clin Endocrinol Metab. 2017;102(3):914-922.
- He S, Tang YH, Zhao G, Yang X, Wang D, Zhang Y. Pioglitazone prescription increases risk of bladder cancer in patients with type 2 diabetes: an updated meta-analysis. Tumour Biol. 2014;35:2095-102.
- Bhushan S, Ray RS, Prakash J, Singh GN. Global Versus Indian Perspective of Pioglitazone-induced Adverse Drug Reactions Including Bladder Cancer: A Comparative Retrospective Pharmacovigilance Analysis. Clin Ther. 2019;41(11):2252-2262.
- Niu SW, Chang KT, Lin HY, Kuo IC, Chang YH, Chen YH, Hung CC, Chiu YW, Hwang SJ. Decreased incidence of gout in diabetic patients using pioglitazone. Rheumatology (Oxford). 2018;57(1):92-99.
- Wu HF, Kao LT, Shih JH, Kao HH, Chou YC, Li IH et al. Pioglitazone use and Parkinson's disease: a retrospective cohort study in Taiwan. BMJ Open. 2018;8(8):e023302.
- Shea MK, Nicklas BJ, Marsh AP, Houston DK, Miller GD, Isom S et al. The effect of pioglitazone and resistance training on body composition in older men and women undergoing hypocaloric weight loss. Obesity (Silver Spring). 2011;19:1636-46.
- Arnetz L, Dorkhan M, Alvarsson M, Brismar K, Ekberg NR. Gender differences in non-glycemic responses to improved insulin sensitivity by pioglitazone treatment in patients with type 2 diabetes. Acta Diabetol. 2014;51(2):185-92.
- Esteghamati A, Noshad S, Rabizadeh S, Ghavami M, Zandieh A, Nakhjavani M. Comparative effects of metformin and pioglitazone on omentin and leptin concentrations in patients with newly diagnosed diabetes: a randomized clinical trial. Regul Pept. 2013;182:1-6.
- Statistikdatabas för läkemedel. Stockholm: Socialstyrelsen. 2020 [cited 2021-03-10.]
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Litteratursökningsdatum: 7/15/2021
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