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Actos Review Article

 

InsulinActos (Generic Name: Pioglitazone) belongs to the class thiazolidinedione (TZD) and is a prescription drug with hypoglycemic action (antihyperglycemic/antidiabetic action). It is used to treat Type 2 Diabetes Mellitus which was known as Non-Insulin-Dependent Diabetes Mellitus (NIDDM). It was also used for the treatment of fatty liver or Non-Alcoholic Steatohepatitis but this use is currently regarded as experimental. Pioglitazone may cause fluid retention and peripheral edema.

Aktos reduces insulin resistance in peripheral tissues and liver

Actos is a brand name of the drug Pioglitazone and is a Thiazolidinedione class. It is used as an antihyperglycemic and antidiabetic medication for type 2 Diabetes Mellitus also called Non-Insulin Dependent Diabetes Mellitus. In addition to this primary usage, Actos is also prescribed for Non-Alcoholic Steatohepatitis or a fatty liver condition. Continue reading...

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It works by stimulating peroxisomes PPAR-? into PPAR-? which entails insulin sensitization activities in the liver, muscles and adipose tissues. This action causes the elimination of glucose which are dependent on insulin and conserves those stored in the liver. Actos and other TZD drugs may also be indicated in combination with other antidiabetic or antihyperglycemic drugs such as sulfonylurea, metformin or insulin.

Previously, Actos was also used to determine level of effectiveness as compared with Glimepiride for a condition known as Coronary Atherosclerotic Disease Progression which is common for Type 2 DM patients. The effects were measured primarily on the Percent Atheroma Volume which was taken both before as baseline data and at week 72 for follow up examinations. Intravascular Ultrasound was also done on the coronary arteries. The researchers found that there is a difference in nominal change between Pioglitazone and Glimepride but only slight to come up with a definite conclusion.

In other cases, Actos has been experimentally prescribed for preventing prediabetes stages to progress to DM type 2. Actos was used in a randomized, safety and efficacy study involving subjects affected with impaired glucose tolerance and type 2 DM. The two groups for Actos and placebo were to undergo treatment for 45 months under continuous examination for signs of IGT through frequently sampled intravenous glucose tolerance test and carotid ultrasounds for carotid intimal media thickness. Fasting Plasma Glucose and Oral Glucose Tolerance Tests were also taken periodically. The researchers aim to validate the current yet experimental use of Actos for prevention of converting IGT to DM type 2.

One of the latest opened studies for Actos is its use for adolescents who are affected with severe sepsis and septic shock. This study is very recent only starting on May 2011 but supporting data from previous studies is that Pioglitazone may be used to decrease the inflammatory biomarkers which significantly increase during body sepsis. The reason behind this is that PPAR-? is a nuclear receptor peroxisome which contributes to controlling the inflammatory response. As Pioglitazone has been shown to decrease this body response in the case of diabetic patients, researchers plan to evaluate and find the same action in the case of septic patients.

References:

1. Nissen SE, Nicholls SJ, Wolski K, Nesto R, Kupfer S, Perez A, Jure H, De Larochelli??re R, Staniloae CS, Mavromatis K, Saw J, Hu B, Lincoff AM, Tuzcu EM, 2008. PERISCOPE Investigators. Comparison of pioglitazone vs glimepiride on progression of coronary atherosclerosis in patients with type 2 diabetes: the PERISCOPE randomized controlled trial. JAMA. 299(13):1561-73.

2. DeFronzo RA, Tripathy D, Schwenke DC, Banerji M, Bray GA, Buchanan TA, Clement SC, Henry RR, Hodis HN, Kitabchi AE, Mack WJ, Mudaliar S, Ratner RE, Williams K, Stentz FB, Musi N, Reaven PD, 2011. ACT NOW Study. Pioglitazone for diabetes prevention in impaired glucose tolerance or Actos Now for Prevention of Diabetes (ACT NOW). N Engl J Med. 364(12):1104-15.

3. Children??s Hospital Medical Center (Verifier). 2011. Pharmacokinetic Characteristics of Pioglitazone and Preliminary Biomarker Response in Adolescents Aged 12 to 17 Years With Severe Sepsis and Septic Shock.


 

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