Two new studies further address the risks of rosiglitazone

For more than 10 years, thiazolidinediones (TZDs) have been prescribed for diabetes therapy in the U.S. on the sole basis of evidence that they improve glycemic control. An association of TZDs with heart failure is relatively well-established; however, recent data have implicated rosiglitazone in other adverse cardiovascular events as well.

Two new studies further address the risks of rosiglitazone. In an observational cohort study, 227,571 Medicare patients (median age, 74.4) began therapy with either rosiglitazone or pioglitazone between July 2006 and June 2009. During a median follow-up of 105 days, rosiglitazone recipients were significantly more likely than pioglitazone recipients to experience adverse events including stroke, heart failure, death from any cause and a composite of acute myocardial infarction (AMI), stroke, heart failure, and death.

In an extension of a well-known 2007 meta-analysis of clinical trials of rosiglitazone (JW Cardiol May 21 2007), researchers examined 56 trials involving 35,531 patients randomized to receive rosiglitazone or a control therapy for more than 24 weeks.

Compared with controls, patients in the rosiglitazone groups had a significantly higher risk for myocardial infarction.