Rosiglitazone : a review of its use in type 2 diabetes mellitus

Rosiglitazone (Avandia) is an antihyperglycaemic agent of the thiazolidinedione class that improves glycaemic control (as indicated by glycosylated haemoglobin [HbA1c] and fasting plasma glucose [FPG] levels) primarily by increasing hepatic and peripheral insulin sensitivity, and in addition may help to preserve pancreatic beta-cell function. In general, rosiglitazone as monotherapy or in combination with other antihyperglycaemic agents, including metformin or sulfonylureas, improves glycaemic control in adults with type 2 diabetes mellitus and may slow disease progression associated with pancreatic beta-cell function decline. Rosiglitazone is generally well tolerated; however, additional long-term and comparative studies are required to further evaluate the effects of rosiglitazone on bone and the potential cardiovascular risk of the drug, including the risk relative to pioglitazone. Thus, in light of recent cardiovascular safety concerns and the need for further long-term data to clarify the potential risk of rosiglitazone in this regard, it would be prudent to use rosiglitazone in the treatment of type 2 diabetes on a case-by-case basis, taking into account individual patient cardiovascular risk factors.