Mannucci E, Giaccari A, Gallo M, et al. - According to findings of this meta-analysis, pioglitazone exerts no significant impacts on incident major adverse cardiovascular events (MACE), all-cause death, and hospitalization for heart failure (HHF) in patients with type 2 diabetes.

• RCTs, with duration≥52 weeks, in which pioglitazone was compared with either placebo or active comparators for type 2 diabetes were identified from the MEDLINE database.

• Experts analyzed eight RCTs for MACEs and HF (5,048 and 5,117 patients in the pioglitazone and control group, respectively), 24 RCTs for all-cause death (10,682 and 9,674 patients).

• Relative to placebo/active comparators, pioglitazone neither significantly elevated nor decreased the risk of MACE, all-cause death, and HHF (Mantel-Haenszel odds ratio, MH-OR: 0.90, 95% CI 0.78-1.03, 0.91, 95% CI 0.77, 1.09, and 1.16, 95% CI 0.73, 1.83, respectively).

• Pioglitazone was found to be linked with a significant decrease of MACE in cases with prior cardiovascular events (MH-OR 0.84).