Adults with type 2 diabetes prescribed the PPAR agonist Actos develop dementia less often than individuals without diabetes, according to research in Annals of Neurology.
In a prospective analysis of observational data from a German public health care database, researchers found that the risk for developing dementia in adults with type 2 diabetes was lower in adults who were prescribed pioglitazone (Actos, Takeda) for longer periods of time compared with adults with type 2 diabetes not taking the drug.
, MD, of the German Center for Neurodegenerative Diseases and the department of neurology at the University of Bonn, Germany, and colleagues analyzed data from 145,928 adults aged 60 years or older who did not have dementia or insulin-dependent diabetes at baseline, using observational data from the largest German mandatory public health insurance, Allgemeine Ortskrankenkassen (AOK), from 2004 to 2010. Researchers distinguished among patients who did not have diabetes, patients with diabetes not prescribed pioglitazone, patients with diabetes with prescriptions of less than 8 calendar quarters of pioglitazone and patients with diabetes with 8 or more quarters of pioglitazone.
Michael T. Heneka
Researchers used Cox proportional hazard models to explore relative risk of dementia incidence dependent on pioglitazone use.
Researchers found that long-term use of pioglitazone was linked with lower incidence of dementia, reducing the risk by 47% compared with patients without diabetes (RR = 0.53; P = .029). For patients with diabetes prescribed pioglitazone for less than 8 quarters, the dementia risk was similar to those without diabetes (RR = 1.16; P = .317). Patients with diabetes who were not prescribed pioglitazone had a 23% increased risk for dementia (RR = 1.23; P < .001).
“Treatment with pioglitazone showed a remarkable side benefit,” Gabriele Doblhammer, PhD, of the University of Rostock in Germany, said in a press release. “It was able to significantly decrease the risk of dementia. The longer the treatment, the lower the risk.”
Researchers noted that patients taking metformin also had a reduced risk for dementia; however, the effect was lower than with pioglitazone.
The study results demonstrate that pioglitazone has a preventive effect, Heneka said in a press release.
“This happens when the drug is taken before symptoms of dementia manifest,” Heneka said. “Thus, it protects in particular against Alzheimer’s, the most common form of dementia. The causes for this, whether pioglitazone only has this protective effect in diabetics or if it would also work in non-diabetics — all these questions have yet to be answered.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.