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[Clinical effect and side effect of troglitazone]
Nihon Rinsho. Japanese Journal of Clinical Medicine
|March 9, 2000
Summary
Troglitazone, a PPAR-gamma agonist for type 2 diabetes, can cause severe liver damage. Monthly liver function tests are recommended for patients to detect drug-induced hepatitis early.
Area of Science:
- Pharmacology
- Hepatology
- Endocrinology
Background:
- Troglitazone is a PPAR-gamma agonist used to treat type 2 diabetes by improving insulin sensitivity.
- The drug has been associated with severe hepatotoxicity, necessitating careful patient monitoring.
Observation:
- Sankyo Pharmaceutical issued a warning regarding troglitazone-induced liver injury.
- In Japan, 153 diabetic patients developed severe hepatitis, with 8 fatalities linked to the drug.
Findings:
- The mechanism of hepatotoxicity is thought to involve the quinone metabolite of troglitazone and activation of PPAR gamma and PXR (pregnane X receptor).
- These factors predominantly occur in the liver, leading to drug-induced liver injury.
Implications:
- Monthly liver function tests are crucial for early detection of drug-induced hepatitis in patients on troglitazone.
- This highlights the importance of pharmacovigilance for new diabetes medications.