Pioglitazone use after stroke. Exploring stroke survivors’ views
Research type
Research Study
Full title
Pioglitazone use after stroke; exploring the views of stroke survivors
IRAS ID
248759
Contact name
Jesse Dawson
Contact email
Sponsor organisation
On Behalf of Research & Development Management Office NHS Greater Glasgow & Clyde
Duration of Study in the UK
0 years, 5 months, 1 days
Research summary
Stroke survivors have a higher risk of second strokes and heart attacks than people who do not have stroke. New treatments are needed to reduce this risk. Recently we learned that a drug called pioglitazone may prevent strokes and heart attacks after stroke in people who are resistant to insulin but do not have diabetes. This may be as many as 1/2 of our patients. Pioglitazone removed roughly ¼ of the risk of a heart attack or stroke. However, it also increased the risk of fracture, by a smaller but not insignificant amount, and it can cause weight gain. This means doctors are unsure whether they should use it and this is a much discussed topic in the stroke community.
Pioglitazone is a drug already used to treat type 2 diabetes so is widely available and cheap. We have surveyed UK stroke physicians and pioglitazone is not used. Guidelines suggest pioglitazone can be considered in individual patients after consideration of the risks and benefits. There is little data on the stroke survivor’s perspectives concerning the trade-offs between the benefits and potential side effects. It is also possible that the frequency of side effects such as fracture and weight gain could be reduced by targeted interventions such as better patient selection, dose reduction, use of calcium and vitamin D and lifestyle measures. These may not be feasible after stroke.
We wish to explore stroke survivors perspectives in order to help us decide whether further clinical trials of pioglitazone are needed and how we can feasibly minimise risks of pioglitazone therapy in after stroke. We will survey up to 500 stroke survivors registered in the Scottish Health Research Register (SHARE). The survey should take no more than 10 minutes to complete.
REC name
North West - Greater Manchester South Research Ethics Committee
REC reference
18/NW/0607
Date of REC Opinion
17 Oct 2018
REC opinion
Further Information Favourable Opinion