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A Review on the Clinical Safety of Thiazolidinediones

Abstracts


Background. The safety issue of thiazolidinediones has been discussed frequently in the past few years because of the main concern of congestive heart failure, myocardial infarction, bladder cancer, and osteoporosis. This review will focus on the safety issue of thiazolidinediones. Findings. Both rosiglitazone and pioglitazone are associated with congestive heart failure, and possibly associated with bone loss. However, rosiglitazone and pioglitazone are not similar in many aspects. Overall, pioglitazone has more favorable effects on cardiovascular diseases and lipid parameters than rosiglitazone. There is a signal of higher bladder cancer risk associated with the use of pioglitazone other than rosiglitazone. The U.S. Food and Drug Administration and the European Medicines Agency are keeping consistent watch on the potential risk of bladder cancer related to pioglitazone. Conclusions. Pioglitazone seems to have more favorable effect than rosiglitazone on lipid parameters and ischemic cardiovascular disease. With regards to the risk of bladder cancer, pioglitazone shows an insignificantly higher risk, but rosiglitazone shows a null association. Many safety issues and adverse effects of thiazolidinediones remain to be confirmed and more randomized clinical trials are warranted.

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