Lee Esther J, Marcy Todd R
University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma, USA.
Consult Pharm. 2014 Aug;29(8):555-8. doi: 10.4140/TCP.n.2014.555.
Type 2 diabetes mellitus (T2DM) is a chronic condition with increasing prevalence and severe complications. Thiazolidinediones have been marketed since 1997 and are effective glucose-lowering drugs, but individual drugs within the class have been linked to serious adverse effects that resulted in the removal of troglitazone from the market, restrictions to rosiglitazone's use, and a warning added to pioglitazone's label. In 2007, a meta-analysis linked rosiglitazone to myocardial infarction (MI). Pioglitazone does not appear to share this risk. To the contrary, pioglitazone may reduce risk for MI. However, retrospective evaluations have increasingly linked pioglitazone to a higher risk of bladder cancer that appears to be time- and dose-dependent. Pioglitazone remains a medication appropriate for consideration in the management of T2DM; however, clinicians and patients should weigh its risks compared with alternatives, with a regular review of risks.
2型糖尿病（T2DM）是一种患病率不断上升且伴有严重并发症的慢性疾病。噻唑烷二酮类药物自1997年上市以来，是有效的降糖药物，但该类药物中的个别药物已被证实与严重不良反应有关，导致曲格列酮退市、罗格列酮的使用受限，吡格列酮的药品标签也增加了警告信息。2007年，一项荟萃分析将罗格列酮与心肌梗死（MI）联系起来。吡格列酮似乎不存在这种风险。相反，吡格列酮可能会降低心肌梗死的风险。然而，回顾性评估越来越多地将吡格列酮与膀胱癌风险增加联系起来，这种风险似乎与时间和剂量有关。吡格列酮仍然是治疗2型糖尿病时适合考虑使用的药物；然而，临床医生和患者应权衡其与其他药物相比的风险，并定期复查风险。
