At least two thiazolidinediones rosiglitazone and pioglitazone--are available in lower-dose formulations in combination with metformin, and the combinations provide the same level of diabetes control as do higher-dose
glitazone monotherapy, he said.
At least two - rosiglita-zone and pioglitazone - are available in lower-dose formulations in combination with metformin, and the combinations provide the same level of diabetes control as does higher-dose
glitazone monotherapy, said Dr.
As an indirect screen for
glitazone (thiazolidinedione)-like activity in V.
Ramsay et al., "Diabetic macular edema associated with
glitazone use," Retina, vol.
Data on the use of the
glitazone drug class for diabetic patients aged 35 years and older who did not have type 1 diabetes were analyzed in four time frames: January 2003-January 2005; February 2005-January 2007, a period when safety concerns were first revealed; February 2007-May 2008, when the FDA issued the advisories on cardiovascular risks and 6 months thereafter; and June 2008-June 2009, wrote Mr.
The controversy over Avandia is not the first time such an issue has surfaced for the
glitazone drug segment.
Here's what triple-drug therapy with metformin, a sulfonylurea, and a
glitazone accomplishes, as demonstrated in a 200-patient trial in which patients on metformin and a sulfonylurea were randomized to troglitazone or placebo.
Glitazone use was associated with an increased risk of diabetic macular edema even after accounting for confounding factors, according to the results of a large, prospective cohort study.
It has been demonstrated that thiazoladinediones and
glitazone decrease fasting blood glucose, cholesterol and triglycerides, and this may result in their potential ability to reduce macrovascular complications (Freie, 1999).
Edema that is not caused by congestive heart failure is not a contraindication for
glitazone use but requires close monitoring and should lead to a consideration of alternate therapy.
In vitro studies have suggested that drugs in the
glitazone class stimulate production of the peroxisome proliferator-activated receptor gamma (PPAR-gamma) protein, which plays a key role in adipocyte differentiation, and clinical trials have linked the drugs to increased subcutaneous fat in people with diabetes.
Nissen if the findings have changed his opinion regarding the
glitazone class of drugs.