Diabetes Drug Linked to Lower Dementia Risk
Long-term use of the diabetes drug pioglitazone (Actos, Takeda Pharmaceuticals) may protect against dementia, an observational study suggests.
The study was presented here at the Alzheimer’s Association International Conference (AAIC) 2014. Abstract #P2-295 Presented July 14, 2014.
Pioglitazone is a peroxisome proliferator activated receptor-γ (PPAR-γ) agonist used to treat type 2 diabetes.
In murine models of Alzheimer’s disease, PPAR-γ activation improves behavioral deficits and neuropathologic changes by suppressing neuroinflammation, increasing β-amyloid clearance, and modulating β-secretase-1 promotor activity.
On the basis of preclinical data, Gabriele Doblhammer, PhD, and colleagues from the German Center for Neurodegenerative Diseases, Bonn, Germany, hypothesized that long-term use with pioglitazone would reduce the risk for dementia.
Using prescription data from a German database, they studied the association of pioglitazone and dementia incidence in a prospective cohort study of 145,717 adults age 60 years and older who were free of dementia at baseline in 2004 and followed until 2010. The information on prescriptions of pioglitazone on a quarterly basis was expressed as a linear variable covering the time-dependent number of quarters of prescriptions, which ranged between 0 and 28 quarters.
In a Cox proportional hazard model, they calculated the relative risk for dementia with use of pioglitazone, adjusted for sex; age; and use of nonsteroidal anti-inflammatory drugs, rosiglitazone, and metformin; and cardiovascular comorbidities, including diabetes, cerebrovascular disease, hypertension, ischemic heart disease, atrial fibrillation, and hypercholesterolemia.
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