Thiazolidinedione safety
Abstract
INTRODUCTION: Thiazolidinediones (TZDs) initially showed great promise as unique receptor-mediated oral therapy for type 2 diabetes, but a host of serious side effects, primarily cardiovascular, have limited their utility. It is crucial at this point to perform a risk-benefit analysis to determine what role TZDs should play in our current treatment of type 2 diabetes and where the future of this class of drugs is headed. AREAS COVERED: This review provides a comprehensive overview of the literature from 2000 onward reporting the known side effects of rosiglitazone and pioglitazone, with commentary on the quality of the data available, putative mechanism of each side effect and clinical significance. Finally, a perspective on the future of the TZDs as a class is provided. EXPERT OPINION: The current TZDs are first-generation, non-specific activators of peroxisome proliferator-activated receptor (PPAR) gamma, resulting in a wide array of deleterious side effects that currently limit their use. However, the development of highly targeted selective PPAR gamma modulators (SPPARγMs) and dual PPAR gamma/alpha agonists is on the horizon.
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Thiazolidinediones were rapidly sidelined as therapeutics because of their potential adverse effects such as an increased risk of myocardial infarction.
“However, thiazolidinediones were rapidly sidelined as therapeutics because of their potential adverse effects such as an increased risk of myocardial infarction (274).”
From Metabolic Flexibility as an Adaptation to Energy Resources and Requirements in Health and Disease (2018) · cites this paper as [274]
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- Authors
- Kung, J., & Henry, R. R.
- Affiliations
- Tufts University (US)
- University of California San Diego (US)
- ORCID
- Henry, Robert R
- Venue
- Expert Opinion on Drug Safety
- Publisher
- Informa UK Limited
- Published
- 2012-05-22
- Volume
- 11
- Issue
- 4
- Pages
- 565-579
- ISSN
- 1474-0338 (ISSN-L)
- 1744-764X
- OpenAlex
- W4236897356
- Cited by
- 198
- References
- 89
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 11 · 2023: 10 · 2022: 10 · 2021: 13 · 2020: 13 · 2019: 14 · 2018: 14 · 2017: 11 · 2016: 24 · 2015: 24 · 2014: 13 · 2013: 23 · 2012: 6
- FWCI
- 2.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Opinion on Drug Safety (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 › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- thiazolidinediones, rosiglitazone, pioglitazone, type 2 diabetes, drug safety, adverse effects, cardiovascular risk, PPARγ agonists, risk-benefit assessment
- MeSH terms
- Urinary Bladder Neoplasms, Diabetes Mellitus, Type 2, Heart Failure, Humans, Hypoglycemic Agents, Liver, Macular Edema, Myocardial Infarction, Thiazolidinediones, PPAR alpha, PPAR gamma, Fractures, Bone
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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