{"id":7014,"date":"2011-03-17T19:38:36","date_gmt":"2011-03-17T23:38:36","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=7014"},"modified":"2011-07-19T17:44:30","modified_gmt":"2011-07-19T21:44:30","slug":"meta-analysis-suggests-worse-outcomes-for-rosiglitazone-compared-to-pioglitazone","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/03\/17\/meta-analysis-suggests-worse-outcomes-for-rosiglitazone-compared-to-pioglitazone\/","title":{"rendered":"Meta-Analysis Suggests Worse Outcomes For Rosiglitazone Compared To Pioglitazone"},"content":{"rendered":"<p>There are no long-term trials directly comparing rosiglitazone and pioglitazone. In <a href=\"http:\/\/www.bmj.com\/cgi\/doi\/10.1136\/bmj.d1309\">an article published in <em>BMJ<\/em><\/a>, Yoon Kong Loke and colleagues performed a systematic review and meta-analysis of 16 observational studies with more than 800,000 thiazolidinedione users in an attempt to assess the relative cardiovascular effects of the two drugs.<\/p>\n<p>When compared with pioglitazone, rosiglitazone was associated with<\/p>\n<ul>\n<li>a\u00a0significant increase in MI (OR 1.16, CI\u00a01.07-1.24; P&lt;0.001),<\/li>\n<li>a significant increase in CHF (OR 1.22, CI 1.14-1.31; P&lt;0.001), and<\/li>\n<li>a significant increase in death (OR\u00a01.14, CI 1.09 to 1.20; P&lt;0.001).<\/li>\n<\/ul>\n<p>They calculated that for every 100,000 patients who received rosiglitazone rather than pioglitazone there would be\u00a0170 excess MIs, 649 excess cases of HF, and 431\u00a0excess deaths.<\/p>\n<p>In an\u00a0<a href=\"http:\/\/www.bmj.com\/cgi\/doi\/10.1136\/bmj.d1354\">accompanying editorial<\/a>, Victor Montori expresses concern over the continuing availability of rosiglitazone in the U.S., and writes that &#8220;research should be undertaken to understand what occurs when drugs are left on the market with strong warnings.&#8221; He also expresses concern that &#8220;regulators and prescribers do not seem to have learnt from the rosiglitazone saga,&#8221; noting that new diabetes drugs have been approved and rapidly adopted by prescribers in recent years.<\/p>\n<p>Montori concludes:<\/p>\n<p style=\"padding-left: 30px;\">&#8220;The rosiglitazone story says much about how healthcare has become less about promoting patients\u2019 interests, alleviating illness, promoting function and independence, and curing disease, and much more about promoting other interests, including those of the drug industry. Has the corruption of healthcare advanced so far that it is unreasonable, even naive, to expect responsible drug companies, enlightened regulators, and thoughtful prescribers?&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>There are no long-term trials directly comparing rosiglitazone and pioglitazone. In an article published in BMJ, Yoon Kong Loke and colleagues performed a systematic review and meta-analysis of 16 observational studies with more than 800,000 thiazolidinedione users in an attempt to assess the relative cardiovascular effects of the two drugs. When compared with pioglitazone, rosiglitazone [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,7],"tags":[415,205,198],"class_list":["post-7014","post","type-post","status-publish","format-standard","hentry","category-general","category-prevention","tag-pioglitazone","tag-rosiglitazone","tag-tzds"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/7014","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=7014"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/7014\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=7014"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=7014"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=7014"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}