Rosiglitazone and Cardiotoxicity — Weighing the Evidence

Publisher Website
Google Scholar
Abstract
The recently published meta-analysis by Nissen and Wolski,1 which suggested a significant increase in the risk of myocardial infarction associated with treatment with rosiglitazone (Avandia) and an increase of similar magnitude, albeit nonsignificant, in the risk of death from cardiovascular causes, has created a furor in the press and a quandary for physicians and their patients. Given the vagaries of meta-analyses in general and of this meta-analysis in particular — owing to the absence of primary or time-to-event data, as acknowledged both in the article and in the accompanying editorial2 — clinicians have been left uncertain as to whether rosiglitazone should still be considered for the treatment of type 2 diabetes. Because millions of patients with diabetes are being treated with rosiglitazone worldwide, the answer to this question has major implications.