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    Diabetes Drug May Help Prevent Second Stroke: Study

    Actos reduced risk by 24 percent in people with insulin resistance, research showed

    WebMD News from HealthDay

    By Steven Reinberg

    HealthDay Reporter

    WEDNESDAY, Feb. 17, 2016 (HealthDay News) -- The diabetes drug Actos (pioglitazone) appears to protect people who've already had a stroke from suffering a second stroke, a new study finds.

    Along with standard treatment after a stroke -- including blood thinners, and blood pressure and cholesterol medication -- the addition of Actos reduced the odds of another stroke by 24 percent compared to a placebo, the researchers said.

    "Actos represents a new option for patients who have had a stroke to help prevent a future stroke," said lead researcher Dr. Walter Kernan, a professor of medicine at Yale School of Medicine in New Haven, Conn.

    For the study, Kernan and colleagues randomly assigned nearly 4,000 patients who had suffered a stroke or a mini-stroke to Actos or a placebo. None of the patients had diabetes but they did have evidence of insulin resistance, putting them at risk for the blood-sugar disease.

    Over nearly five years of follow-up, 9 percent of those taking Actos had another stroke or heart attack, compared with nearly 12 percent of those receiving placebo, the researchers found.

    Nearly 4 percent of those taking Actos developed diabetes, compared with nearly 8 percent of those taking the placebo, the study showed.

    The report was published online Feb. 17 in the New England Journal of Medicine. The study was also scheduled to be presented Wednesday at the American Stroke Association's annual meeting, in Los Angeles. Funding for the study was provided by the U.S. National Institutes of Health.

    No one knows how Actos works to prevent stroke, Kernan said. The best guess is that the drug reduces inflammation, improves insulin resistance, helps manage fats in the body and "favorably affects the function of blood vessels," he said. "These could explain its effects on recurrence of stroke and heart attack."

    Insulin resistance may also play a part in the risk for stroke, Kernan said. "This trial provides fairly strong evidence that insulin resistance is an important new target for prevention of stroke," he said. "This trial takes preventive neurology in a new direction and opens up new opportunities for the care of patients."

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