LDL and apoB
Pioglitazone does not change CETP or improve peripheral vessel function in nondiabetic patients over nine months (Cardiology 2015)
Original title: Effects of the Peroxisome Proliferator-Activated Receptor-γ Agonist Pioglitazone on Peripheral Vessel Function and Clinical Parameters in Nondiabetic Patients: A Double-Center, Randomized Controlled Pilot Trial
In a prospective, double-blind, placebo-controlled pilot trial (the PPP Trial), 54 nondiabetic patients were randomized to the PPAR-gamma agonist pioglitazone or placebo, with pulse wave velocity, retinal vessel function, and carotid intima-media thickness assessed after 9 months. No relevant differences emerged between groups in pulse wave velocity, retinal arterial diameter, or intima-media thickness. Biochemical markers, including CETP, LDL cholesterol, high-sensitivity C-reactive protein, and white blood cell count, also showed no significant difference in change between groups, leading the authors to conclude pioglitazone did not improve peripheral vessel function or these biochemical markers in nondiabetic patients.
Original abstract
Objective: Despite the advanced therapy with statins, antithrombotics, and antihypertensive agents, the medical treatment of atherosclerotic disease is less than optimal. Therefore, additional therapeutic antiatherosclerotic options are desirable. This pilot study was performed to assess the potential antiatherogenic effect of the peroxisome proliferator-activated receptor-γ agonist pioglitazone in nondiabetic patients.
Methods: A total of 54 nondiabetic patients were observed in a prospective, double-blind, placebo-controlled study. Patients were randomized to pioglitazone or placebo. The following efficacy parameters were determined by serial analyses: artery pulse wave analysis and carotid-femoral pulse wave velocity (PWV), static and dynamic retinal vessel function, and the common carotid intima-media thickness (IMT). The main secondary endpoint was the change in different biochemical markers.
Results: After 9 months, no relevant differences could be determined in the two treatment groups in PWV (pioglitazone 14.3 ± 4.4 m/s vs. placebo 14.2 ± 4.2 m/s), retinal arterial diameter (pioglitazone 112.1 ± 23.3 µm vs. placebo 117.9 ± 21.5 µm) or IMT (pioglitazone 0.85 ± 0.30 mm vs. placebo 0.79 ± 0.15 mm). Additionally, there were no differences in the change in biochemical markers like cholesteryl ester transfer protein, low-density lipoprotein cholesterol, high-sensitivity C-reactive protein or white blood cell count.
Conclusions: Treatment with a peroxisome proliferator-activated receptor-γ agonist in nondiabetic patients did not improve the function of large and small peripheral vessels (PPP Trial, clinicaltrialsregister.eu: 2006-000186-11).
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.