Cardiovascular risk and thiazolidinediones--what do meta-analyses really tell us?

Diabetes Obes Metab. 2010 Dec;12(12):1023-35. doi: 10.1111/j.1463-1326.2010.01262.x.

Abstract

Meta-analyses of clinical trials suggest that the use of the thiazolidinedione (TZD), rosiglitazone, in patients with type 2 diabetes mellitus may increase the risk of myocardial ischaemic events by 30-40%. Although these controversial data must be interpreted with caution, in the absence of definitive prospective cardiovascular (CV) outcomes data, they represent a prominent source of evidence concerning the CV safety of rosiglitazone. The results of meta-analyses and a large randomized-controlled CV outcomes trial provide strong evidence that pioglitazone does not increase the risk of coronary events. This article clarifies the clinical significance of these meta-analytical findings alongside other sources of evidence and assesses their impact on evolving treatment guidelines and recommendations for the use of TZDs in patients with type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / chemically induced*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetic Angiopathies / chemically induced*
  • Female
  • Humans
  • Male
  • Meta-Analysis as Topic*
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Rosiglitazone
  • Thiazolidinediones / adverse effects*

Substances

  • Thiazolidinediones
  • Rosiglitazone