This systematic review and meta-analysis ascertained Pioglitazone's effectiveness and safety in enhancing cognitive function in Alzheimer's disease.

Publications from the past 12 years were identified from databases including Cochrane Central, Scopus, PubMed, and other trial registries. Those studies that investigated Pioglitazone (15-30 mg) with other oral hypoglycemic agents, diabetic diet, or placebo over a duration of at least six months were included. Overall, 525 records were screened, resulting in the inclusion of 5 studies for quantitative assessment. Extraction of data was carried out utilizing a pretested form. Utilizing Cochrane's risk of bias assessment tool, this was followed by a risk of bias assessment.

In Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores, Pioglitazone did not exhibit a substantial betterment [mean difference (MD): -1.16; 95% confidence interval (CI): -4.14-1.81]. However, sensitivity analysis, excluding 1 study, revealed pivotal efficacy [MD: -2.75; 95% CI: -4.84--0.66]. In the Pioglitazone arm, the Wechsler Memory Scale-Revised logical memory I (WMS-R) scores illustrated a remarkable betterment [MD: 2.02; 95% CI: 0.09-3.95].

Pioglitazone represents a safe intervention and holds promise in attenuating the progression of Alzheimer's disease.