In a nutshell
This study analyzed the effectiveness of pioglitazone (Actos) in patients with prediabetes or type 2 diabetes (T2D) and nonalcoholic fatty liver disease (NAFLD). The authors concluded that pioglitazone can significantly improve liver function in these patients.
Some background
NAFLD is the accumulation of fat cells in the liver. NAFLD commonly occurs in patients with T2D, although the underlying cause is unknown. Weight reduction is important in the treatment of NAFLD. However, in many patients this is not enough and medications may be needed.
Diabetes medications that improve sensitivity to insulin (the hormone necessary to reduce blood glucose levels) such as pioglitazone have been studied in patients with T2D and NAFLD. However, the effectiveness of this medication on liver function in these patients is still not clear.
Methods & findings
This study analyzed 4 clinical trials of pioglitazone in the treatment of patients with prediabetes or T2D and NAFLD. The studies lasted between 4 and 18 months.
Pioglitazone treatment significantly improved the fatty deposits in the liver (steatosis) by 78% compared to placebo. Patients treated with pioglitazone were 2.05 times more likely to have significant improvements in inflammation grade compared to those given placebo.
Patients treated with pioglitazone were 76% more likely to have a resolution of NAFLD compared to placebo. Patients treated with pioglitazone were also 2.35 times more likely to have improvements in any liver parameters compared to placebo.
Compared to placebo, pioglitazone significantly improved glucose metabolic function, high-density lipoprotein (HDL or "good" cholesterol), and liver enzymes (liver function tests).
Compared to placebo, pioglitazone treatment was 64% more likely to cause side effects such as low blood glucose, swelling in the feet, upper abdominal pain, and chest, back or joint pains.
The bottom line
The study suggested that pioglitazone can improve liver parameters and blood glucose in patients with prediabetes or T2D with NAFLD.
The fine print
The sample sizes of the studies analyzed were small. Also, the follow-up periods were short. Further studies are needed.
Published By :
Frontiers in Endocrinology
Date :
May 18, 2021
