Rosiglitazone and cardiotoxicity –weighing the evidence
Open accessAbstract
The recently published meta-analysis by Nissen and Wolski,1 which suggested a significant increase in the risk of myocardial infarction associated with treatment with rosiglitazone (Avandia) and an increase of similar magnitude, albeit nonsignificant, in the risk of death from cardiovascular causes, has created a furor in the press and a quandary for physicians and their patients. Given the vagaries of meta-analyses in general and of this meta-analysis in particular — owing to the absence of primary or time-to-event data, as acknowledged both in the article and in the accompanying editorial2 — clinicians have been left uncertain as to whether rosiglitazone . . .
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Thiazolidinediones (PPAR-gamma agonists) are powerful insulin sensitizers effective in lowering insulin resistance and preventing type 2 diabetes, with efficacy similar to lifestyle strategies and greater than metformin.
“Among the pharmacologic strategies, the thiazolidenidiones, also known as PPAR-gamma agonists, are powerful insulin sensitizers effective in lowering insulin resistance [66] and preventing T2D [67], with efficacy similar to lifestyle strategies and greater than metformin [68].”
From Metformin in Amnestic Mild Cognitive Impairment: Results of a Pilot Randomized Placebo Controlled Clinical Trial (2016) · cites this paper as [67]
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- Authors
- Nathan, D. M.
- Affiliations
- Harvard University (US)
- Corresponding author
- Nathan, David M.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2007-07-05
- Volume
- 357
- Issue
- 1
- Pages
- 64-66
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2008001887
- Cited by
- 126
- References
- 10
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 1 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 5 · 2015: 6 · 2014: 6 · 2013: 1 · 2012: 2
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Peroxisome Proliferator-Activated Receptors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- rosiglitazone, cardiotoxicity, myocardial infarction risk, cardiovascular mortality, meta-analysis critique, time-to-event data, thiazolidinediones, type 2 diabetes
- MeSH terms
- Rosiglitazone, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Heart Failure, Humans, Hypoglycemic Agents, Metformin, Sulfonylurea Compounds, Thiazolidinediones
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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