Pioglitazone may not reduce macrovascular events

doi:10.1136/bmj.331.7520.0-d

BMJ 2005;331 (8 October), doi:10.1136/bmj.331.7520.0-d

Pioglitazone may not reduce macrovascular events

On page 836, Freemantle challenges the interpretation of a newtrial on the oral antidiabetic drug pioglitazone. Members ofthe trial's steering committee presented the results of thetrial last month at a conference in Athens. The committee membersclaimed that the trial showed that pioglitazone, which lowersblood glucose concentration, can prevent macrovascular events.Freemantle says that this interpretation is based on secondaryoutcomes (the primary outcome remained neutral), and he explainswhy the conclusions presented may be statistically unsound andunsafe.