thiazolidinedione; glitazone; TZD
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Introduction
see pioglitazone, rosiglitazone
See recommendations of the American Diabetes Association & the American Heart Association
Indications
- treatment of diabetes mellitus type 2
- reduced risk for blindness (RR = 0.71)[4]
- reduced risk for dementia (22%)[5]
- reduced risk of breast cancer (RR=0.87)[6]
- reduced risk of lung cancer (RR=0.77)[6]
- reduced risk of liver cancer (RR=0.83)[6]
Adverse effects
- weight gain
- fluid retension, edema
- heart failure
- macular edema
- osteoporosis & increased risk of bone fractures[3]
- hypoglycemia (RR = 1.22)[4]
Mechanism of action
- PPAR-gamma agonist
- PPAR-gamma regulates transcription of insulin-responsive genes
- increases peripheral uptake of glucose
- decreases hepatic glucose production[3]
Notes
- used as monotherapy or in combination with sulfonylurea, associated with increased risk of renal failure relative to metformin monotherapy[4]
More general terms
More specific terms
Additional terms
References
- ↑ Nesto RW et al Thiazolidinedione use, fluid retention, and congestive heart failure: a consensus statement from the American Heart Association and American Diabetes Association. October 7, 2003. Circulation 108:2941, 2003 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/14662691 <Internet> http://circ.ahajournals.org/cgi/content/full/108/23/2941
- ↑ Kaul S, Bolger AF, Herrington D et al Thiazolidinedione drugs and cardiovascular risks: a science advisory from the American Heart Association and American College Of Cardiology Foundation. J Am Coll Cardiol. 2010 Apr 27;55(17):1885-94 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20413044
- ↑ 3.0 3.1 3.2 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
NEJM Knowledge+ Endocrinology
Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009 Jan 6;180(1):32-9. Epub 2008 Dec 10. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19073651 PMCID: PMC2612065 Free PMC article
Viscoli CM et al. Pioglitazone and risk for bone fracture: Safety data from a randomized clinical trial. J Clin Endocrinol Metab 2017 Mar; 102:914 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27935736 https://academic.oup.com/jcem/article-abstract/102/3/914/3061916/Pioglitazone-and-Risk-for-Bone-Fracture-Safety - ↑ 4.0 4.1 4.2 4.3 Hippisley-Cox J, Coupland C Diabetes treatments and risk of amputation, blindness, severe kidney failure, hyperglycaemia, and hypoglycaemia: open cohort study in primary care. BMJ 2016;352:i1450 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27029547 <Internet> http://www.bmj.com/content/352/bmj.i1450
Montori VM Selecting the right drug treatment for adults with type 2 diabetes. BMJ 2016;352:i1663 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27029501 <Internet> http://www.bmj.com/content/352/bmj.i1663 - ↑ 5.0 5.1 Tucker ME One Type of Older Diabetes Drug Cuts Dementia Risk, Another Ups It. Medscape. Oct 11, 2022 https://www.medscape.com/viewarticle/982256
Tang X et al Use of oral diabetes medications and the risk of incident dementia in US veterans aged >= 60 years with type 2 diabetes. BMJ Open Diabetes Research & Care. 2022 10(5): PMID: https://www.ncbi.nlm.nih.gov/pubmed/36220195 PMCID: PMC9472121 Free PMC article https://drc.bmj.com/content/10/5/e002894 - ↑ 6.0 6.1 6.2 6.3 Chen Y et al Diabetes medications and cancer risk associations: a systematic review and meta-analysis of evidence over the past 10 years. Sci Rep. 2023 13(1):11844. July 22. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37481610 PMCID: PMC10363143 Free PMC article https://rdcu.be/dh4Er