Published 29 September 2009, doi:10.1136/bmj.b3957
Cite this as: BMJ 2009;339:b3957

Letters

Rosiglitazone and pioglitazone

Beware fractures

The first 150 words of the full text of this article appear below.

Juurlink and colleagues show that pioglitazone has fewer adverse cardiovascular outcomes than rosiglitazone, which may be a class effect.1 However, recent reports show that thiazolidinediones are associated with increased incidence of fractures.

By 2007 the manufacturers of pioglitazone had advised health professionals about the risk of fractures in women on the basis of clinical trial data outcomes.2 Recent reports show that both men and women who take thiazolidinediones for diabetes could be at increased risk of distal fractures of upper and lower limbs,3 4 5 the risk increasing with age.

The black box warning from the US Food and Drug Administration a few years after the introduction of thiazolidinediones, the withdrawal of troglitazone because of rare cases of severe hepatotoxicity, and the increased risk of fractures have raised concerns. Do the benefits of treatment outweigh the risks? Are thiazolidinediones the treatment of choice for type 2 diabetes?

Cite this as: BMJ 2009;339:b3957

Alok Dixit, assistant professor1, Pinki Pandey, assistant professor1

1 M M Institute of Medical Science and Research, Mullana, Ambala, India 133203

alkdxt@yahoo.co.in

. . . [Full text of this article]


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

Adverse cardiovascular events during treatment with pioglitazone and rosiglitazone: population based cohort study
David N Juurlink, Tara Gomes, Lorraine L Lipscombe, Peter C Austin, Janet E Hux, and Muhammad M Mamdani
BMJ 2009 339: b2942. [Abstract] [Full Text] [PDF]

Access jobs at BMJ Careers
Whats new online at Student BMJ