Department of Medicine, University of California at San Diego, San Diego, CA 92161, USA.
Expert Opin Drug Saf. 2010 Mar;9(2):347-54. doi: 10.1517/14740331003623218.
Thiazolidinediones (TZDs) are useful glucose-lowering agents for patients with Type 2 diabetes. Through PPAR-gamma-mediated effects, these drugs not only improve insulin sensitivity and glycemia, they also have beneficial effects on lipid metabolism and the vascular endothelium, with potential to improve cardiovascular risk. However, this promise has not been entirely fulfilled. The first TZD, troglitazone, was withdrawn after reports of severe liver damage. The second TZD, rosiglitazone, has been reported in meta-analyses to be associated with possible increased risk of cardiovascular disease (CVD) events. The third TZD approved for clinical use in the US, pioglitazone, appears to be associated with decreased CVD events in most studies/meta-analyses.
We undertook a literature search in Pubmed from the year 2000 onwards to review the side effect/safety profile of pioglitazone.
A comprehensive summary of the currently available data on the side effect/safety profile of pioglitazone.
The main adverse effects reported with pioglitazone are those common to the TZD class: weight gain, pedal edema, bone loss and precipitation of congestive heart failure in at-risk individuals, without any increase in CVD/all-cause mortality. Overall, the safety profile of pioglitazone is favorable and remains a useful option for the treatment of insulin-resistant patients with Type 2 diabetes. Further studies are needed to confirm/clarify its cardiovascular benefits.
噻唑烷二酮类（TZDs）是 2 型糖尿病患者有用的降血糖药物。通过过氧化物酶体增殖物激活受体-γ（PPAR-γ）介导的作用，这些药物不仅改善胰岛素敏感性和血糖水平，还对脂质代谢和血管内皮有有益影响，有可能改善心血管风险。然而，这一承诺并没有完全实现。第一种 TZD，曲格列酮，在报告严重肝损伤后被撤回。第二种 TZD，罗格列酮，在荟萃分析中被报道可能与心血管疾病（CVD）事件风险增加有关。第三种在美国获得临床使用批准的 TZD，吡格列酮，在大多数研究/荟萃分析中似乎与 CVD 事件减少有关。
我们在 Pubmed 上进行了从 2000 年开始的文献检索，以综述吡格列酮的副作用/安全性概况。
对吡格列酮副作用/安全性概况的现有数据的全面总结。
报告的吡格列酮的主要不良反应与 TZD 类药物常见的不良反应相同：体重增加、足部水肿、骨丢失和充血性心力衰竭在高危个体中的发生，没有增加 CVD/全因死亡率。总体而言，吡格列酮的安全性良好，仍然是治疗 2 型糖尿病胰岛素抵抗患者的有效选择。需要进一步的研究来证实/澄清其心血管益处。
