The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Rosiglitazone: A Thunderstorm from Scarce and Fragile Data

Cynthia D. Mulrow, MD, MSc, Deputy Editor; John Cornell, PhD, Associate Editor; and A. Russell Localio, PhD, Associate Editor
[+] Article, Author, and Disclosure Information

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Customer Service, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.

Ann Intern Med. 2007;147(8):585-587. doi:10.7326/0003-4819-147-8-200710160-00013
Text Size: A A A

The U.S. Food and Drug Administration (FDA) has approved many pharmacotherapies for treating diabetes on the basis of the drugs' ability to improve glycemic control. Although preventing adverse macrovascular outcomes, such as myocardial infarction, is a desirable goal for treatment of type 2 diabetes, there is no definitive evidence that any FDA-approved pharmacotherapy achieves such aims (1). Worse, recent meta-analyses suggest that rosiglitazone, a widely prescribed oral hypoglycemic agent, might increase the risk for ischemic heart disease by a small amount. We examine the fragile data underpinning that story and the challenges of summarizing trials with scarce events.



First Page Preview

View Large
First page PDF preview





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Insurance Institute of Medication Information
Posted on October 18, 2007
Marcus M. Reidenberg
Weill Cornell Medical College
Conflict of Interest: None Declared

To The Editor:

The editorial, "Rosiglitazone: A thunderstorm from scarce and fragile data", asks for large studies "designed and funded by parties representing the public interest". Third party payers for medical care have both a moral responsibility to their patients and the most to gain financially from having toxic medicines identified and head-to-head comparisons of alternative therapies carried out. The health insurers should follow the example of the automobile insurers who formed the Insurance Institute for Highway Safety. These insurers pay 0.019% of premiums to fund this Institute to do research and promote highway safety (1). If private health insurers paid 0.019% of premiums, an Insurance Institute of Medication Information would have a budget of $104 million annually. If public payers also participated, the funding would more than double to do the kind of studies proposed in the editorial.

(1) Reidenberg MM. Improving how we evaluate the toxicity of approved drugs. Clin Pharmacol Ther 2007; 80: 1-6

Conflict of Interest:

None declared

Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.