Safety and efficacy of rosiglitazone in the elderly diabetic patient

Viljoen, Adie

doi:10.2147/vhrm.s4053

Cited by 16 publications

(11 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, the insulin-sensitizing drug pioglitazone has recently been linked to an increased risk of bladder cancer. Older people with Type 2 diabetes are especially vulnerable to the adverse effects of thiazolidinediones, which include the potential for serious cardiovascular, skeletal and ocular complications [101,112]. Given the inherently higher risk of cancer in older people, this observation underscores the need for care when selecting glucose-lowering drugs as long-term therapy.…”

Section: Cancer and Insulin Resistancementioning

confidence: 99%

“…Given the inherently higher risk of cancer in older people, this observation underscores the need for care when selecting glucose-lowering drugs as long-term therapy. Older people with Type 2 diabetes are especially vulnerable to the adverse effects of thiazolidinediones, which include the potential for serious cardiovascular, skeletal and ocular complications [101,112].…”

Section: Cancer and Insulin Resistancementioning

confidence: 99%

See 1 more Smart Citation

Insulin resistance: a risk marker for disease and disability in the older person

2013

View full text Add to dashboard Cite

Clinical metabolic studies have demonstrated that insulin action declines progressively with age in humans. In addition to its close association with Type 2 diabetes, which reduces life expectancy in older people, age-related insulin resistance is implicated in pathogenesis of several highly prevalent disorders for which ageing is a major risk factor. These include atherosclerotic cardiovascular disease, dementia, frailty and cancer. Accordingly, insulin resistance may be viewed as biomarker of age-related ill health and reduced lifespan. The rapidly rising number of older people, coupled with a high prevalence of insulin resistance resulting from obesity and sedentary lifestyles, presents unprecedented public health and societal challenges. Studies of centenarians have shown that preserved whole-body sensitivity to insulin is associated with longevity. The mechanisms through which insulin action is associated with age-related diseases remain unclear. Changes in body composition, i.e. sarcopenia and excess adiposity, may be more potent than age per se. Moreover, the impact of insulin resistance has been difficult to disentangle from the clustering of vascular risk factors that co-segregate with the insulin resistance-hyperinsulinaemia complex. Potentially modifiable mediators of age-related changes in insulin sensitivity include alterations in adipocytokines, impaired skeletal myocyte mitochondrial function and brown fat activity. The hypothesis that improving or maintaining insulin sensitivity preserves health and extends lifespan merits further evaluation. Practical non-pharmacological interventions directed against age-related insulin resistance remain underdeveloped. Novel metabolically active pharmacological agents with theoretical implications for some age-related disorders are entering clinical trials. However, recent adverse experiences with the thiazolidinediones suggest the need for a cautious approach to the use of insulin sensitizing drugs in older people. This could be particularly important in the absence of diabetes where the risk to benefit analysis may be less favourable.

show abstract

Section: Cancer and Insulin Resistancementioning

confidence: 99%

Section: Cancer and Insulin Resistancementioning

confidence: 99%

Insulin resistance: a risk marker for disease and disability in the older person

2013

View full text Add to dashboard Cite

show abstract

“…At least 20% of all patients over the age of 65 years suffer from diabetes, and this number is expected to grow rapidly in the coming decades (Viljoen, Sinclair, 2009).…”

Section: Antidiabetic Drugsmentioning

confidence: 99%

Elderly and drugs: risks and necessity of rational use

Baldoni

Chequer

Ferraz

et al. 2010

Braz. J. Pharm. Sci.

View full text Add to dashboard Cite

In recent decades, the world has undergone a demographic transformation with a rapid growth of the elderly population, resulting in an increased demand for funds to maintain their health and drug consumption. Pharmacokinetic and pharmacodynamic changes occurring in the elderly can interfere directly in the adverse effects of drugs and increase the risk of intoxication. In addition, there are external factors interfering with the pharmacotherapy of the elderly, such as inappropriate use and the lack of access to information. Many therapeutic classes of drugs should be used with caution or avoided in the elderly population, such as anti-inflammatory and some anti-hypertensive drugs, diuretics and digitalis. If not managed carefully, these medicines can affect the safety and quality of life in the elderly. Thus, the aim of this review was to identify drugs that should be used with caution in elderly patients in order to avoid intoxication and/or adverse drug events.Uniterms: Elderly/inappropriate medicines. Medicines/consumption. Medicines/adverse reaction. Medicines/intoxication. Medicine/rational use. Medicine/inappropriate prescribing.Durante as últimas décadas, o mundo passou por uma transformação demográfica, com um rápido crescimento da população idosa e, portanto, tanto a demanda para a manutenção da saúde deste grupo populacional, quanto o consumo de medicamentos estão aumentando. Ainda, as mudanças farmacocinéticas e farmacodinâmicas que ocorrem em idosos podem interferir diretamente nos efeitos adversos dos medicamentos e aumentar o risco de intoxicação. Além disso, há fatores externos que interferem na farmacoterapia dos idosos, tais como o uso inadequado e a falta de acesso à informação. Existem várias classes terapêuticas de medicamentos que devem ser utilizados com cautela ou evitados na população idosa, tais como antiinflamatórios, alguns anti-hipertensivos, diuréticos, digitálicos entre outros. Estes medicamentos, se não forem utilizados com cuidado, podem afetar a qualidade de vida e a segurança desta população. Assim, este trabalho visa identificar medicamentos que devem ser utilizados com cuidado em pacientes idosos para evitar intoxicações e/ou eventos adversos aos medicamentos.Unitermos: Idosos/medicamentos inadequados. Medicamentos/consumo. Medicamentos/reação adversa. Intoxicação medicamentosa. Medicamentos/uso racional. Prescrição inapropriada.

show abstract

“…In the clinic, elderly patients with T2D receive the same pharmacological therapy as the younger adult cohort [54]. More than 20% of the population over 65 years old has diabetes [55]. Our studies provide persuasive motivation to study effects of drugs in different age groups of animals to predict usage related safety and toxicity aspects.…”

Section: Discussionmentioning

confidence: 99%

Fish oil decreases inflammation and reduces cardiac remodeling in rosiglitazone treated aging mice

Halade

Williams

Lindsey

et al. 2011

Pharmacological Research

View full text Add to dashboard Cite

Clinical studies suggest that rosiglitazone (RSG) treatment may increase the incidence of heart failure in diabetic patients. In this study, we examined whether a high corn oil diet with RSG treatment in insulin resistant aging mice exerted metabolic and pro-inflammatory effects that stimulate cardiac dysfunction. We also evaluated whether fish oil attenuated these effects. Female C57BL/6J mice (13 months old) were divided into 5 groups: (1) lean control (LC), (2) corn oil, (3) fish oil, (4) corn oil + RSG and (5) fish oil + RSG. Mice fed a corn oil enriched diet and RSG developed hypertrophy of the left ventricle (LV) and decreased fractional shortening, despite a significant increase in total body lean mass. In contrast, LV hypertrophy was prevented in RSG treated mice fed a fish oil enriched diet. Importantly, hyperglycemia was controlled in both RSG groups. Further, fish oil + RSG decreased LV expression of atrial and brain natriuretic peptides, fibronectin and the pro-inflammatory cytokines interleukin-6 and tumor necrosis factor-α, concomitant with increased interleukin-10 and adiponectin levels compared to the corn oil + RSG group. Fish oil + RSG treatment suppressed inflammation, increased serum adiponectin, and improved fractional shortening, attenuating the cardiac remodeling seen in the corn oil + RSG diet fed C57BL/6J insulin resistant aging mice. Our results suggest that RSG treatment has context-dependent effects on cardiac remodeling and serves a negative cardiac role when given with a corn oil enriched diet.

show abstract

Safety and efficacy of rosiglitazone in the elderly diabetic patient

Cited by 16 publications

References 52 publications

Insulin resistance: a risk marker for disease and disability in the older person

Insulin resistance: a risk marker for disease and disability in the older person

Elderly and drugs: risks and necessity of rational use

Fish oil decreases inflammation and reduces cardiac remodeling in rosiglitazone treated aging mice

Contact Info

Product

Resources

About