Pioglitazone use is associated with reduced risk of Parkinson’s disease in patients with diabetes: A systematic review and meta-analysis

This meta-analysis aimed to evaluate the effect of pioglitazone on Parkinson's disease (PD) in diabetes patients.A study search was carried out in PubMed, Embase, and Web of Science databases from inception to July 22, 2021. The Newcastle-Ottawa scale was used to evaluate the quality of the eligible studies. The risk ratio (RR) and 95% confidence intervals (CI) were used as effect size indicators in this meta-analysis to evaluate the risk association between pioglitazone and PD. The Cochran's Q and IThree studies were eligible for this meta-analysis. Compared with diabetes patients who did not use pioglitazone, there was a significant reduction in the risk of PD (RR of 0.87 [95 % CI 0.62-0.99, P = 0.039]) in pioglitazone users. No significant difference in PD risk was noted in diabetes patients taking 438 dose-duration-days (DDDs) of pioglitazone or lower compared with those who did not. When the DDD of pioglitazone was 438, the RR was 0.85 (95 % CI [0.72-1.00], P = 0.05). When the DDD of pioglitazone was 438, the risk of PD in patients with diabetes was significantly decreased (P 0.05) and showed an approximate linear correlation trend.Pioglitazone administration in PD in diabetes patients is significantly associated with a decrease in the risk of PD.