Rosiglitazone

In the years that followed the launch of rosiglitazone, there were many papers on its usefulness for patients with diabetes. There were papers that showed the drug’s effectiveness in reducing blood sugar when used alone (article) and also when used in combination with sulphonylureas (article) or metformin (article) . Some other notable trials that showed beneficial effects of rosiglitazone were the DREAM trial and the ADOPT trial. In the DREAM trial investigators showed that rosiglitazone could reduce the development of diabetes in those who had impaired fasting glucose or impaired glucose tolerance while the ADOPT trial showed that rosiglitazone was better than metformin or a sulphonylurea in maintaining glycemic control as monotherapy.

Problems with the drug began to surface in 2007. In early 2007, the first reports that rosiglitazone was associated with osteoporosis and an increased fracture risk appeared - See here. Then, in June 2007 a meta analysis published in the New England Journal of Medicine showed that patients on rosiglitazone had a greater risk of suffering a myocardial infarction - (Read the article). There was a lot of public debate on this matter but the drug was allowed to remain in the market with a black box warning on its packaging. Three years later, in July 2010, another meta analysis was published in the Archives of Internal Medicine using randomised trials on rosiglitazone up to February 2010. Again, there was evidence that the use of rosiglitazone was associated with an increased risk of myocardial infarctions. Abstract. So now it is clear that there is a need for extreme caution when prescribing rosiglitazone. Whether it will remain in the market, or whether it will be withdrawn, remains to be seen.

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