Pioglitazone: From development to clinical practice

Summary:

In the 1960s and 1970s, the worldwide search for new lipid-lowering and antihyperglycaemic therapies intensified. The goal was to find new treatments that would act differently from the fibrates. During this time, the pathogenesis of insulin resistance was further explored. Takeda Research Laboratories developed respective new diabetic animal models, which resulted in the synthesis of the first insulin sensitisers. Pioglitazone, a member of the thiazolidinedione class, was identified in the early 1980s as a compound that was able to reduce hyperglycaemia and also hyperlipidaemia. Pioglitazone requires insulin for its action, and its mechanism of action distinctly differs from that of other classes of oral antidiabetic drugs. Although the full mechanism of action of thiazolidinediones is not yet completely understood, their recent introduction represents the first opportunity to specifically treat a main underlying disease factor in type 2 diabetes: insulin resistance. This supplement summarizes some of the recent scientific evidence with pioglitazone and its use in everyday clinical management of patients with type 2 diabetes.

Key words:

Insulin resistance, pioglitazone, pharmacokinetics, safety, efficacy