Thiazolidinedione safety

被引:182
作者
Kung, Jacqueline [1 ]
Henry, Robert R. [2 ,3 ]
机构
[1] Tufts Univ, Div Endocrinol Diabet & Metab, Boston, MA 02111 USA
[2] Univ Calif San Diego, Div Endocrinol & Metab, San Diego, CA 92103 USA
[3] VA San Diego Healthcare Syst, San Diego, CA USA
关键词
peroxisome proliferator-activated receptor (PPAR) gamma agonists; pioglitazone; rosiglitazone; thiazolidinediones; type; 2; diabetes; TYPE-2; DIABETES-MELLITUS; RANDOMIZED CONTROLLED-TRIAL; ADVERSE CARDIOVASCULAR EVENTS; ACUTE MYOCARDIAL-INFARCTION; RECEPTOR-GAMMA AGONISTS; CORONARY-HEART-DISEASE; GLYCEMIC CONTROL; DOUBLE-BLIND; PPAR-GAMMA; ANTIDIABETIC AGENTS;
D O I
10.1517/14740338.2012.691963
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: Thiazolidinediones (TZDs) initially showed great promise as unique receptor-mediated oral therapy for type 2 diabetes, but a host of serious side effects, primarily cardiovascular, have limited their utility. It is crucial at this point to perform a risk-benefit analysis to determine what role TZDs should play in our current treatment of type 2 diabetes and where the future of this class of drugs is headed. Areas covered: This review provides a comprehensive overview of the literature from 2000 onward reporting the known side effects of rosiglitazone and pioglitazone, with commentary on the quality of the data available, putative mechanism of each side effect and clinical significance. Finally, a perspective on the future of the TZDs as a class is provided. Expert opinion: The current TZDs are first-generation, non-specific activators of peroxisome proliferator-activated receptor (PPAR) gamma, resulting in a wide array of deleterious side effects that currently limit their use. However, the development of highly targeted selective PPAR gamma modulators (SPPAR gamma Ms) and dual PPAR gamma/alpha agonists is on the horizon.
引用
收藏
页码:565 / 579
页数:15
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