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thiazolidinedione; glitazone; TZD

see pioglitazone, rosiglitazone See recommendations of the American Diabetes Association & the American Heart Association Indications: - treatment of diabetes mellitus type 2 - reduced risk for blindness (RR = 0.71) [4] - reduced risk for dementia (22%) [5] - reduced risk of breast cancer (RR=0.87) [6] - reduced risk of lung cancer (RR=0.77) [6] - reduced risk of liver cancer (RR=0.83) [6] Adverse effects: - weight gain - fluid retension, edema - heart failure - macular edema - osteoporosis & increased risk of bone fractures [3] - hypoglycemia (RR = 1.22) [4] Mechanism of action: - PPAR-gamma agonist - PPAR-gamma regulates transcription of insulin-responsive genes - increases peripheral uptake of glucose - decreases hepatic glucose production [3] Notes: - used as monotherapy or in combination with sulfonylurea, associated with increased risk of renal failure relative to metformin monotherapy [4]

Interactions

drug interactions drug adverse effects (more general classes) monitor with thiazolidinediones (glitazones)

Related

recommendations for prescribing thiazolidinediones (glitazones, TZDs) from the American Diabetic Association and the American Heart Association

Specific

pioglitazone (Actos) rosiglitazone (Avandia) troglitazone (Rezulin)

General

oral hypoglycemic agent

Database Correlations

PUBCHEM cid=5437

References

  1. Nesto RW et al Thiazolidinedione use, fluid retention, and congestive heart failure: a consensus statement from the American Heart Association and American Diabetes Association. October 7, 2003. Circulation 108:2941, 2003 PMID: 14662691 http://circ.ahajournals.org/cgi/content/full/108/23/2941
  2. Kaul S, Bolger AF, Herrington D et al Thiazolidinedione drugs and cardiovascular risks: a science advisory from the American Heart Association and American College Of Cardiology Foundation. J Am Coll Cardiol. 2010 Apr 27;55(17):1885-94 PMID: 20413044
  3. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015 - NEJM Knowledge+ Endocrinology - Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009 Jan 6;180(1):32-9. Epub 2008 Dec 10. PMID: 19073651 PMCID: PMC2612065 Free PMC article - Viscoli CM et al. Pioglitazone and risk for bone fracture: Safety data from a randomized clinical trial. J Clin Endocrinol Metab 2017 Mar; 102:914 PMID: 27935736 https://academic.oup.com/jcem/article-abstract/102/3/914/3061916/Pioglitazone-and-Risk-for-Bone-Fracture-Safety
  4. Hippisley-Cox J, Coupland C Diabetes treatments and risk of amputation, blindness, severe kidney failure, hyperglycaemia, and hypoglycaemia: open cohort study in primary care. BMJ 2016;352:i1450 PMID: 27029547 http://www.bmj.com/content/352/bmj.i1450 - Montori VM Selecting the right drug treatment for adults with type 2 diabetes. BMJ 2016;352:i1663 PMID: 27029501 http://www.bmj.com/content/352/bmj.i1663
  5. Tucker ME One Type of Older Diabetes Drug Cuts Dementia Risk, Another Ups It. Medscape. Oct 11, 2022 https://www.medscape.com/viewarticle/982256 - Tang X et al Use of oral diabetes medications and the risk of incident dementia in US veterans aged >= 60 years with type 2 diabetes. BMJ Open Diabetes Research & Care. 2022 10(5): PMID: 36220195 PMCID: PMC9472121 Free PMC article https://drc.bmj.com/content/10/5/e002894
  6. Chen Y et al Diabetes medications and cancer risk associations: a systematic review and meta-analysis of evidence over the past 10 years. Sci Rep. 2023 13(1):11844. July 22. PMID: 37481610 PMCID: PMC10363143 Free PMC article https://rdcu.be/dh4Er

Substructures

thiazolidine