The results indicate that treatment with Actos lowered triglycerides, increased HDL-C or “good” cholesterol, and improved LDL-C or “bad” cholesterol particle concentration and particle size.
Diabetic dyslipidemia is a condition commonly found in people with type 2 diabetes and is an important risk factor for cardiovascular disease. It is characterized by increased triglycerides and decreased HDL-C. People with diabetic dyslipidemia also tend to have normal levels of LDL-C, but smaller, denser LDL-C particles that are likely to contribute to cholesterol build-up in arteries.
The 24-week randomized clinical trial studied 802 people with type 2 diabetes and dyslipidemia. After a four-week period in which they discontinued their current medication and received a placebo, patients were randomized to receive either 30 mg of Actos once daily for 12 weeks then 45 mg once daily for the remainder of the study, or 4 mg of Avandia once a day for 12 weeks followed by 4 mg twice daily for the remainder of the study.
The study showed that blood glucose control was improved in both Actos- and Avandia-treated patients, but that each treatment differed significantly in their effects on blood lipids. For example, triglyceride levels decreased 12% in the Actos patients but rose 14.9% in the Avandia patients. HDL-C rose 14.9% in the Actos patients and only 7.8% in the Avandia patients, Finally, LDL-C particle concentration was reduced with Actos and increased with Avandia.
“Many factors can contribute to the increased risk of cardiovascular disease in people with diabetes, including multiple lipid abnormalities,” said Robert Spanheimer, medical director for diabetes and metabolism at Takeda Pharmaceuticals. “It is important to understand the impact medications can have on individual lipid parameters.”
He added that the new findings require further research in order to determine whether the results may affect cardiovascular risk.
Actos and Avandia are insulin sensitizers belonging to the thiazolidinedione class of oral anti-diabetes medications that have been approved by the FDA to improve blood glucose control in type 2 diabetes as an adjunct to diet and exercise.