Prakash Deedwania, MD
In patients with type 2 diabetes mellitus (DM), how do rosiglitazone and pioglitazone compare for cardiovascular (CV) outcomes and mortality?
Included studies compared rosiglitazone with pioglitazone in patients with type 2 DM. Outcomes were myocardial infarction (MI), congestive heart failure, and overall mortality.
MEDLINE and EMBASE/Excerpta Medica (to Sep 2010), US Food and Drug Administration Web site, European Medicines Agency Web site, study registers of GlaxoSmithKline and Takeda, and reference lists of included studies and recent review articles were searched for cohort and case–control studies that presented odds ratios, relative risks, hazard ratios, or sufficient data to calculate odds ratios. 16 observational studies (n = 810 000; mean age range 54 to 76 y; mean 55% men in 15 studies) met the selection criteria. 12 studies were retrospective cohort studies, and 4 were case–control studies. Mean or median follow-up ranged from 105 days to 7.1 years.
Moderate statistical heterogeneity existed across study results for myocardial infarction (I2 = 46%, P = 0.03) and heart failure (I2 = 37%, P = 0.13) but not mortality (I2 = 0%, P = 0.68). Meta-analysis showed that rosiglitazone was associated with greater risk for MI, heart failure, and mortality than was pioglitazone.
In patients with type 2 diabetes, use of rosiglitazone is associated with increased risk for cardiovascular outcomes and mortality compared with pioglitazone.
Rosiglitazone vs pioglitazone in type 2 diabetes*
*CI defined in Glossary.
Deedwania P. Review: Rosiglitazone increases risk for cardiovascular outcomes and mortality compared with pioglitazone in type 2 diabetes. Ann Intern Med. ;155:JC2–12. doi: 10.7326/0003-4819-155-4-201108160-02012
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Published: Ann Intern Med. 2011;155(4):JC2-12.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism.
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