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Evidence summaries

Rosiglitazone for Type 2 Diabetes Mellitus

Rosiglitazone is not effective in improving patient-oriented outcomes such as mortality, morbidity, costs and health-related quality of life for type 2 diabetes mellitus. It appears to increase the occurrence of oedema and the risk of myocardial infarction. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 18 studies with a total of 3888 subjects. Longest duration of therapy was four years with a median of 26 weeks. Published studies of at least 24 weeks rosiglitazone treatment in people with type 2 diabetes mellitus did not provide evidence that patient-oriented outcomes like mortality, morbidity, adverse effects, costs and health-related quality of life are positively influenced by this compound. Metabolic control measured by glycosylated haemoglobin A1c (HbA1c) as a surrogate endpoint did not demonstrate clinically relevant differences to other oral antidiabetic drugs. Occurrence of oedema was significantly raised (OR 2.27, 95% confidence interval (CI) 1.83 to 2.81). The single large RCT (ADOPT - A Diabetes Outcomes Progression Trial) indicated increased cardiovascular risk . New data on raised fracture rates in women reveal extensive action of rosiglitazone in various body tissues.

References

  • Richter B, Bandeira-Echtler E, Bergerhoff K, Clar C, Ebrahim SH. Rosiglitazone for type 2 diabetes mellitus. Cochrane Database Syst Rev 2007 Jul 18;(3):CD006063. [PubMed]

Primary/Secondary Keywords