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Letters |16 February 1999

Troglitazone-Associated Hepatic Failure

Brent A. Neuschwander-Tetri, MD; William L. Isley, MD; Julie C. Oki, PharmD

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Author, Article, and Disclosure Information
  • St. Louis University School of Medicine; St. Louis, MO 63110 (Neuschwander-Tetri) St. Lukes Hospital; Kansas City, MO 64111 (Isley) University of Missouri-Kansas City School of Medicine; Kansas City, MO 64108 (Oki)
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Dr. Misbin's update on troglitazone hepatotoxicity based on reports to the FDA is indeed worrisome. It would appear that some patients can experience an unpredictable yet fatal progression of liver disease well into the course of treatment. Delayed elevation of liver enzyme levels was noted in the initial published review of the clinical trials data (1), yet the analysis of this relatively small and well-controlled initial experience led to the conclusion that the enzyme changes were uniformly reversible (2). If minor elevations in ALT levels (<3 times the upper limit of normal) can be a harbinger...
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Neuschwander-Tetri BA, Isley WL, Oki JC. Troglitazone-Associated Hepatic Failure. Ann Intern Med. 1999;130:330. doi: https://doi.org/10.7326/0003-4819-130-4-199902160-00010

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Published: Ann Intern Med. 1999;130(4_Part_1):330.

DOI: 10.7326/0003-4819-130-4-199902160-00010

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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