@article {Anderson4862, author = {John Anderson and Kevin Mortimer and Linhua Pang and Katherine Smith and Helen Bailey and Alan Knox and Tim Harrison}, title = {A double blind randomised placebo controlled trial of the PPAR-gamma agonist pioglitazone in mild asthma}, volume = {42}, number = {Suppl 57}, elocation-id = {4862}, year = {2013}, publisher = {European Respiratory Society}, abstract = {IntroductionActivation of peroxisome proliferator-activated receptor gamma (PPAR-γ) modulates inflammatory gene transcription, and may be a novel therapeutic target for asthma (Nie et al. J Biol Chem 2005; 280(4):2550-61). To determine whether activating PPAR-γ results in measurable clinical effects in asthma, we performed a single centre randomised, parallel group, double blind, placebo controlled trial using the PPAR-γ agonist, pioglitazone (PIO).Methods68 non-smokers with asthma (taking as-required short-acting bronchodilators \& 0-800mcg beclometasone) were randomised to PIO (n=34) or placebo (n=34). The primary outcome was the adjusted mean FEV1 at 12 weeks. Secondary outcomes were adjusted mean morning and evening peak expiratory flow (PEF), asthma control \& quality of life questionnaires, exhaled nitric oxide, bronchial hyper-responsiveness, induced sputum cell counts \& adverse events (AE) at 12 weeks. Outcomes were adjusted for baseline value and other covariates and compared with ANCOVA. The full analysis (FA) included 55 completed cases \& the per-protocol analysis (PPA) 52.ResultsThere was no significant difference in the adjusted mean FEV1 (-0.014 L, 95 \% CI -0.15 to 0.12, p=0.84) or any of the secondary outcomes at 12 weeks in the FA. The PPA replicated the FA, except for a significantly lowered adjusted evening PEF in the PIO group at 12 weeks (-21.33 L/min 95\% CI -39.15 to -3.51 p=0.02). There were more reported AEs (40\% vs. 32\%) \& a lower adjusted haemoglobin in the PIO group at 12 weeks (-0.53 g/dL 95\% CI -0.96, -0.11, p=0.015).Conclusion PPAR-γ agonists are not promising treatments for mild asthma.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/42/Suppl_57/4862}, eprint = {https://erj.ersjournals.com/content/42/Suppl_57/4862.full.pdf}, journal = {European Respiratory Journal} }