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drug adverse effects of thiazolidinediones

Adverse effects: 1) New or worsening macular edema. Some cases improve after stopping or reducing glitazone. 2) increased risk of heart failure (pioglitazone & rosiglitazone) 3) increased risk of myocardial ischemia (rosiglitazone) 4) decreased bone formation, accelerated bone loss, increased risk of fractures (wrist & hip) [4,5,11] a) higher risk was noted in women (odds ratio = 2.23) but not in men (odds ratio = 1.00) [6,7] b) class effect [8,11] 5) increased risk of bladder cancer with long-term use (>= 5 years, RR=2.5 relative to sulfonylurea use) [9]

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DRUGS: thiazolidinedione FORM: drug adverse effects thiazolidinedione

References

  1. Prescriber's Letter 13(2): 2006 Detail-Document#: 220205 (subscription needed) http://www.prescribersletter.com
  2. Lincoff AM et al, Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes. JAMA 2007, 298:1180
  3. Lipscombe LL et al Thiazolidinediones and cardiovascular outcomes in older patients with diabetes. JAMA. 2007 Dec 12;298(22):2634-43. PMID: 18073359
  4. Meier C, Kraenzlin ME, Bodmer M, Jick SS, Jick H, Meier CR. Use of thiazolidinediones and fracture risk. Arch Intern Med. 2008 Apr 28;168(8):820-5. PMID: 18443256
  5. Kahn SE et al, Rosiglitazone-associated fractures in type 2 diabetes: An analysis from A Diabetes Outcome Progression Trial (ADOPT). Diabetes Care 2008, 31:845 PMID: 18223031
  6. Loke YK et al. Long-term use of thiazolidinediones and fractures in type 2 diabetes: A meta-analysis. CMAJ 2009 Jan 6; 180:32. PMID: 19073651
  7. Habib ZA et al Thiazolidinedione use and the longitudinal risk of fractures in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab 2010 Feb; 95:592. PMID: 20061432
  8. Bilik D et al. Thiazolidinediones and fractures: Evidence from Translating Research into Action for Diabetes. J Clin Endocrinol Metab 2010 Oct; 95:4560 PMID: 20631021
  9. Mamtani R et al. Association between longer therapy with thiazolidinediones and risk of bladder cancer: A cohort study. J Natl Cancer Inst 2012 Sep 19; 104:1411 PMID: 22878886
  10. 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
  11. 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