Congestive heart failure rosiglitazone

Although these medications are highly efficacious, the adverse effects of weight gain, congestive heart failure, increased bone fracture risk in women, and possible (for rosiglitazone) worsening of cardiovascular risk potentially limit their popularity and future use. 

A 78-year-old man became short of breath. He had been taking rosiglitazone 8 mg/day for 6 months. He had renal insufficiency, atrial fibrillation, hypertension, and congestive heart failure, with pitting edema and bilateral pleural effusions. He was refractory to intravenous furosemide and metolazone. Withdrawal of rosiglitazone and administration of bumetanide gave a net fluid output of 9.5 litres and the edema resolved. 

Placebo-controlled trials meta-analysis results by outcome for pioglitazone and rosiglitazone. MACE, major adverse cardiovascular event CV death, cardiovascular death Ml, myocardial inferction Serious M. Isch., serious myocardial ischemia Total M. Isch., total myocardial ischemia and CHF, congestive heart failure. 

The safety of rosiglitazone has continued to be examined. The 2010 FDA metaanalysis did not include large trials, but included data from 52 studies of 2 months to 2 years duration in a total of 12 069 patients, mean age 58 years, 59% men, with a mean BMI of 30 kg/m [98 ]. The odds ratio for myocardial infarction in those taking rosiglitazone was 1.8 and for congestive heart failure 1.93. These data support the continued concern about the use of rosiglitazone in type 2 diabetes. 

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