Pioglitazone’s role in the induction of atheroma regression in diabetics was suggested by several RCT. The aim of our study was to evaluate this role through a systematic review of all RCT conducted on this subject. Literature was searched for relevant studies. We included all RCT that compared pioglitazone versus other antidiabetic agents. Mean differences of either AV or CIMT, HbA1C, HDL, and LDL between the two groups were used to assess the effect of pioglitazone versus alternative therapies. Six RCT were included with a total of 1180 patients. Pioglitazone was significantly superior to glimepiride and gliclazide in improving IMT. No significant difference was observed in overall AV, HbA1C, and LDL. The latter findings confirm that anti-atheroma action of pioglitazone is not achieved through its antiglycemic or antidyslipidemia effects, but probably through a DNA-mediated effect, and may lead to its repurposing for reversal of organ fibrosis.

中文翻译：

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吡格列酮作为抗糖尿病药对2型糖尿病患者动脉粥样硬化消退的影响：系统评价和荟萃分析

几个RCT提示了吡格列酮在糖尿病患者诱发动脉粥样硬化消退中的作用。我们研究的目的是通过对该主题进行的所有RCT的系统评价来评估这种作用。在文献中进行了相关研究。我们纳入了所有比较吡格列酮与其他抗糖尿病药的RCT。两组之间AV或CIMT，HbA1C，HDL和LDL的平均差异用于评估吡格列酮与替代疗法的疗效。纳入6项RCT，共1180例患者。吡格列酮在改善IMT方面明显优于格列美脲和格列齐特。在总体AV，HbA1C和LDL中未观察到显着差异。后一发现证实吡格列酮的抗动脉粥样硬化作用不能通过其抗血糖或血脂异常的作用来实现，