Evidence map›Paper›PMID 28057658›Full record

SynthesisBMJ open2017

Pioglitazone and cardiovascular outcomes in patients with insulin resistance, pre-diabetes and type 2 diabetes: a systematic review and meta-analysis.

Hung-Wei Liao, Jeffrey L Saver, Yi-Ling Wu, Tso-Hsiao Chen, Meng Lee, Bruce Ovbiagele

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 7 pooled it
15.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 7 syntheses or guidelines pooled it, 194 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  4. Guideline
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Trial
  9. Trial
  10. Trial
  11. Article
  12. Review
  13. Review
  14. Article
  15. Review
  16. Drug Repositioning in Doxorubicin-Induced Cardiotoxicity Protection.International journal of molecular sciences · 2025
    Review
  17. Review
  18. Review
  19. Review
  20. Review

31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 3 countries.

Hung-Wei LiaoJia-Yi Clinic, Taoyuan, Taiwan.
Jeffrey L SaverUCLA Stroke Center, Los Angeles, California, USA.
Yi-Ling WuDepartment of Neurology, Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan.
Tso-Hsiao ChenDepartment of Nephrology, School of Medicine, College of Medicine, Taipei Medical University, Wan Fang Hospital, Taipei, Taiwan.
Meng LeeDepartment of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Bruce OvbiageleDepartment of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA.
Chang Gung University · TWChiayi Chang Gung Memorial Hospital · TWMedical University of South Carolina · USStroke Association · GBTaipei Medical University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the effect of pioglitazone in people with insulin resistance, pre-diabetes and type 2 diabetes. DESIGN AND

settingSystematic review and meta-analysis of randomised, controlled trials. DATA SOURCES: Literature searches were performed across PubMed, EMBASE, MEDLINE and Cochrane Central Register of Controlled Trials from 1966 to May 2016 to identify randomised, controlled trials with more than 1 year follow-up. OUTCOME MEASURES: Relative risk (RR) with 95% CI was used to evaluate the association between pioglitazone and the risk of major adverse cardiovascular events (MACE: composite of non-fatal myocardial infarction, non-fatal stroke and cardiovascular death) and safety outcomes, after pooling data across trials in a fixed-effects model.

resultsNine trials with 12 026 participants were enrolled in the current meta-analysis. Pioglitazone therapy was associated with a lower risk of MACE in patients with pre-diabetes or insulin resistance (RR 0.77, 95% CI 0.64 to 0.93), and diabetes (RR 0.83, 95% CI 0.72 to 0.97). Risks of heart failure (RR 1.32; CI 1.14 to 1.54), bone fracture (RR 1.52, 95% CI 1.17 to 1.99), oedema (RR, 1.63; CI 1.52 to 1.75) and weight gain (RR 1.60; CI 1.50 to 1.72) increased in pioglitazone group.

conclusionsPioglitazone was associated with reduced risk of MACE in people with insulin resistance, pre-diabetes and diabetes mellitus. However, the risks of heart failure, bone fracture, oedema and weight gain were increased.

Indexed as

Insulin ResistanceCardiovascular DiseasesDiabetes Mellitus, Type 2EdemaFractures, BoneHumansHypoglycemic AgentsPioglitazonePrediabetic StateProtective FactorsRandomized Controlled Trials as TopicThiazolidinedionesWeight GainHypoglycemic AgentsPioglitazoneThiazolidinediones

Identifiers

PMID28057658
PMCPMC5223642
OpenAlexW2568525643

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.