The effects of rosiglitazone on atherosclerotic progression in patients with Type 2 diabetes at high cardiovascular risk

Abstract

Rosiglitazone reduced carotid artery plaque thickness, though not significantly, and there was no significant change in intima media thickness or other ultrasonic indices of carotid arterial disease. There were significant improvements in glycaemic control, insulin sensitivity and fibrinolytic, but not inflammatory, markers. There was no evidence in this study of any adverse effects on progression of carotid arterial disease.

The inhibitory effect of celecoxib and rosiglitazone on experimental endometriosis

“…Pioglitazone, another TZD used in the treatment of type 2 diabetes, has FDA warnings on its use as well. Several studies that have evaluated rosiglitazone's cardiovascular safety, included elderly diabetes patients with high cardiovascular risk, and when compared to pioglitazone, it seems safer than rosiglitazone (47,48), but the matter is still controversial (49)(50)(51).…”

Traditional Risk Factors are Causally Related to Carotid Intima-Media Thickness Progression: Inferences from Observational Cohort Studies and Interventional Trials

“…Compared with placebo, troglitazone treatment did not reduce C-IMTp in insulin-requiring type 2 diabetics [92]. Similarly, rosiglitazone did not affect C-IMTp in patients with T2DM [93,94] or prediabetes [95]. Conversely, pioglitazone (the only thiazolidinedione still in commerce), reduced C-IMTp in patients with impaired glucose tolerance (versus placebo) [96] and in patients with T2DM, as compared with either glimepiride [97] or with non-thiazolidinedione oral anti-diabetic drugs [98].…”

“…Worth noting, several studies included in this review (n=24 out of 161 studies) did not find associations between traditional risk factors and C-IMTp or favorable changes in C-IMTp with interventions that reduce the alluded risk factors. However, a detailed scrutiny of these studies allowed us to identify, in most cases, one or more explanations to these negative results: a) the population was very young and had baseline IMT in the normal range [51,64]; b) the time of observation was relatively short (1 year) to detect significant associations or changes in the sample investigated [51,64,93,94,167] and/or c) IMTp was evaluated only in the distal 1 cm of the common carotid artery, a segment hardly affected by atherosclerosis [24,40,42,43,51,64,81,84,92,122,123]. Actually, negative studies without one or more of these features (3 observational[49,74,112] and 5 interventional [56,57,95,101,152] were uncommon, which underline the importance of an attentive consideration of methodological aspects in the design of studies aimed to ascertain the clinical significance of C-IMTp.…”

Determinants of evolving metabolic and cardiovascular benefit/risk profiles of rosiglitazone therapy during the natural history of diabetes: molecular mechanisms in the context of integrated pathophysiology

“…Indeed, a number of experimental studies in vitro and in animal models have shown that TZDs, including rosiglitazone, possess a broad spectrum of antiatherogenic effects (75,80,151,161) that may be expected to delay the development of atherosclerosis and protect against plaque progression. Despite promising preclinical data, human studies, including the VICTORY trial, have failed to observe significant antiatherosclerotic effects of rosiglitazone (11,12,54,153,168), although a tendency to reduce plaque progression has been observed in some subgroups of diabetic patients (60). Nevertheless, an increased risk of coronary heart disease has been observed in patients treated with rosiglitazone (117), whereas the majority of published studies do not suggest a similar increased risk of cardiovascular events in pioglitazone-treated patients (86).…”