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Troglitazone. Is it all over?

L J Wagenaar1, E M Kuck, J B Hoekstra

  • 1Department of Internal Medicine, Diakonessenhuis Utrecht, The Netherlands.

The Netherlands Journal of Medicine
|August 4, 1999
PubMed
Summary
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Troglitazone, a new drug for type 2 diabetes, improves insulin sensitivity and lowers glucose, insulin, and triglyceride levels. However, it carries a risk of liver dysfunction, necessitating cautious use as a second-line treatment.

Area of Science:

  • Pharmacology
  • Endocrinology
  • Hepatology

Background:

  • Troglitazone, a thiazolidinedione, was introduced in 1997 to improve insulin sensitivity.
  • It effectively lowers glucose, insulin, and triglyceride levels in patients with type 2 diabetes.

Purpose of the Study:

  • To evaluate the efficacy and safety of troglitazone.
  • To assess its role in managing type 2 diabetes, particularly in patients intolerant to metformin.

Main Methods:

  • Clinical trials were conducted to observe the effects of troglitazone.
  • Post-marketing surveillance identified potential adverse events, specifically liver dysfunction.

Main Results:

  • Troglitazone demonstrated efficacy in improving glycemic control and lipid profiles.

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  • However, cases of severe liver dysfunction, including fatalities, were reported.
  • The drug's introduction in Europe was halted due to these safety concerns.

    • Conclusions:

    • Troglitazone is a valuable agent for type 2 diabetes, especially for patients unsuitable for metformin.
    • The risk of hepatotoxicity warrants its use as a second-line therapy with careful monitoring.