Cardiovascular risk of rosiglitazone: another perspective

J Pharm Pharmacol. 2008 Dec;60(12):1573-82. doi: 10.1211/jpp.60.12.0002.


Rosiglitazone is an effective therapy for type 2 diabetes although concerns have grown about the incidence of oedema and cardiovascular adverse events in patients treated with the drug. The following review was conducted to evaluate further and complement the evidence linking rosiglitazone with an increased risk for cardiovascular adverse events by examining trials and case reports not included in recent meta-analyses. Rosiglitazone-related publications describing case reports and prospective and retrospective cohort analyses were identified using MEDLINE and EMBASE, from July 1999 to July 2007. Relevant reports cited in these publications were also obtained. A recently-published meta-analysis and a double-blind, randomized, placebo-controlled trial were also reviewed. This review of 20 case reports and 10 uncontrolled studies supports the need for added vigilance when prescribing rosiglitazone to patients for the treatment of type 2 diabetes who may be at risk for congestive heart failure. Clinical data from numerous case reports and uncontrolled studies suggested that patients receiving rosiglitazone should be monitored for the development of weight gain or oedema. Prudence should be observed in patients with a history or risk factors for congestive heart failure as they may be poor candidates for rosiglitazone therapy.

Publication types

  • Review

MeSH terms

  • Adverse Drug Reaction Reporting Systems
  • Cardiovascular Diseases / chemically induced*
  • Clinical Trials as Topic
  • Diabetes Mellitus, Type 2 / drug therapy
  • Drug Monitoring / methods
  • Edema / chemically induced
  • Humans
  • Hypoglycemic Agents / adverse effects*
  • Hypoglycemic Agents / therapeutic use
  • Patient Selection
  • Risk Factors
  • Rosiglitazone
  • Thiazolidinediones / adverse effects*
  • Thiazolidinediones / therapeutic use
  • Weight Gain / drug effects


  • Hypoglycemic Agents
  • Thiazolidinediones
  • Rosiglitazone