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Efficacy and Cardiovascular Safety of Thiazolidinediones

Arkiath Veettil Raveendran1, Cornelius James Fernandez2, Koshy Jacob3

  • 1Department of Internal Medicine, Badr Al Samaa group of hospitals, Barka, Oman.

Current Drug Safety
|October 27, 2020
PubMed

Insights

Thiazolidinediones (TZDs) improve glycemic control in type 2 diabetes by preserving beta-cell function. This review highlights TZD efficacy and cardiovascular safety, crucial for managing patients with diabetes and cardiovascular disease risk.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Type 2 diabetes mellitus (T2DM) involves beta-cell dysfunction and insulin resistance, often linked to ectopic fat accumulation.
  • Insulin sensitizers are vital for T2DM management.
  • Ectopic fat in liver and muscle drives insulin resistance in T2DM and metabolic syndrome.

Purpose of the Study:

  • To review the efficacy and cardiovascular (CV) safety of thiazolidinediones (TZDs) in managing type 2 diabetes.
  • To emphasize the role of TZDs in preserving pancreatic beta-cell function for durable glycemic control.
  • To discuss the importance of CV safety in T2DM pharmacotherapy, especially in light of recent cardiovascular outcome trials (CVOTs).

Main Methods:

  • Literature review focusing on thiazolidinediones (TZDs).
  • Analysis of data from cardiovascular outcome trials (CVOTs) concerning GLP-1 receptor agonists (GLP-1 RAs) and sodium glucose transporter-2 inhibitors (SGLT2i).
  • Emphasis on efficacy and CV safety profiles of available TZD agents.

Main Results:

  • Thiazolidinediones (TZDs) are insulin sensitizers that preserve pancreatic beta-cell function.
  • TZDs contribute to durable glycemic control in type 2 diabetes.
  • Recent CVOTs demonstrate cardiovascular safety for GLP-1 RAs and SGLT2i.

Conclusions:

  • Drugs with proven cardiovascular safety are preferred for T2DM patients with existing or at-risk cardiovascular disease.
  • Thiazolidinediones (TZDs) offer a valuable therapeutic option due to their efficacy and beta-cell preserving properties.
  • This review details the efficacy and CV safety of the three available TZD drugs.
Keywords:
Pioglitazonecardiovascular diseaseglycemic controlheart failureinsulin resistancerosiglitazone

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