Thiazolidinedione Use, Fluid Retention, and Congestive Heart Failure

Nesto, Richard W.; Bell, David S.H.; Bonow, Robert O.; Fonseca, Vivian; Grundy, Scott M.; Horton, Edward S.; Winter, M.; Porte, Daniel; Semenkovich, Clay F.; Smith, Sidney; Young, Lawrence H.; Kahn, Richard

doi:10.2337/diacare.27.1.256

Cited by 655 publications

(427 citation statements)

References 41 publications

(29 reference statements)

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“…The intent of this article is to clarify and reinforce the notion that our organizations remain unified and committed to reducing the burden of diabetes and CVD. The importance of identifying and treating a core set of risk factors (prediabetes, hypertension, dyslipidemia, and obesity) cannot be overstated, and our commitment is evidenced by other previous joint publications (42,43). While unrelated to an underlying metabolic abnormality, tobacco use also deserves special attention.…”

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confidence: 80%

Preventing Cardiovascular Disease and Diabetes

et al. 2006

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confidence: 80%

Preventing Cardiovascular Disease and Diabetes

et al. 2006

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“…Although the development of edema is relatively common, the development of heart failure is infrequent and is reported in 1-3% of patients receiving thiazolidinediones either alone or in combination with insulin (15,16,27). Prior studies suggest that PPAR␥ agonists can reduce peripheral vascular resistance and improve cardiac output (28).…”

Section: Safetymentioning

confidence: 99%

Improvement of Glycemic Control, Triglycerides, and HDL Cholesterol Levels With Muraglitazar, a Dual (α/γ) Peroxisome Proliferator–Activated Receptor Activator, in Patients With Type 2 Diabetes Inadequately Controlled With Metformin Monotherapy

et al. 2006

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OBJECTIVE -We sought to evaluate the effects of muraglitazar, a dual (␣/␥) peroxisome proliferator-activated receptor (PPAR) activator within the new glitazar class, on hyperglycemia and lipid abnormalities. RESULTS -Analyses were conducted at week 24 for HbA 1c (A1C) and at week 12 for lipid parameters. Mean A1C at baseline was 8.12 and 8.13% in muraglitazar and pioglitazone groups, respectively. At week 24, muraglitazar reduced mean A1C to 6.98% (Ϫ1.14% from baseline), and pioglitazone reduced mean A1C to 7.28% (Ϫ0.85% from baseline; P Ͻ 0.0001, muraglitazar vs. pioglitazone). At week 12, muraglitazar and pioglitazone reduced mean plasma triglyceride (Ϫ28 vs. Ϫ14%), apolipoprotein B (Ϫ12 vs. Ϫ6%), and non-HDL cholesterol (Ϫ6 vs. Ϫ1%) and increased HDL cholesterol (19 vs. 14%), respectively (P Ͻ 0.0001 vs. pioglitazone for all comparisons). At week 24, weight gain (1.4 and 0.6 kg, respectively) and edema (9.2 and 7.2%, respectively) were observed in the muraglitazar and pioglitazone groups; at week 50, weight gain and edema were 2.5 and 1.5 kg, respectively, and 11.8 and 8.9%, respectively. At week 50, heart failure was reported in seven patients (five with muraglitazar and two with pioglitazone), and seven deaths occurred: three from sudden death, two from cerebrovascular accident, and one from pancreatic cancer in the muraglitazar group and one from perforated duodenal ulcer in the pioglitazone group. RESEARCH DESIGN AND METHODSCONCLUSIONS -We found that 5 mg muraglitazar resulted in greater improvements in A1C and lipid parameters than a submaximal dose of 30 mg pioglitazone when added to metformin. Weight gain and edema were more common when muraglitazar was compared with a submaximal dose of pioglitazone.

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“…Mechanistically, this may relate to increased renal reabsorption of sodium, a reduction of systemic vascular resistance, or other mechanisms. 32,33 Unlike troglitazone, no data link pioglitazone or rosiglitazone to drug-induced hepatotoxicity. 34,35 Nevertheless, it is recommended that drug therapy not be started if the alanine aminotransferase (ALT) is > 2.5 times the upper limit of normal and stopped if the ALT is > 3 times the upper limit of normal (Table 1).…”

Section: Metforminmentioning

confidence: 99%

Drug Interactions of Medications Commonly Used in Diabetes

Triplitt¹

2006

Diabetes Spectrum

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Thiazolidinedione Use, Fluid Retention, and Congestive Heart Failure

Cited by 655 publications

References 41 publications

Preventing Cardiovascular Disease and Diabetes

Preventing Cardiovascular Disease and Diabetes

Improvement of Glycemic Control, Triglycerides, and HDL Cholesterol Levels With Muraglitazar, a Dual (α/γ) Peroxisome Proliferator–Activated Receptor Activator, in Patients With Type 2 Diabetes Inadequately Controlled With Metformin Monotherapy

Drug Interactions of Medications Commonly Used in Diabetes

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