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Glitazones Not Superior to Older Diabetes Drugs

There is no convincing evidence they lead to better results when used as monotherapy

MONDAY, April 14 (HealthDay News) -- There is no convincing evidence that glitazones are superior as a monotherapy compared to older type 2 diabetes treatments, according to a review published in the April issue of the Drug and Therapeutics Bulletin.

The review assessed glitazones in light of long-term evidence that has now accumulated and found that while their use in combination with metformin or a sulphonylurea continues to be supported by evidence, there is no convincing evidence of their superiority as monotherapy, there is only weak evidence of their benefit as part of triple therapy, and they should only be used in patients who cannot benefit from insulin.

Glitazones also cause weight gain, can cause peripheral edema and heart failure, and increase the risk of fracture in women, the authors note. Moreover, rosiglitazone is contraindicated in patients with acute coronary syndrome because of increased risk of myocardial infarction and cardiovascular disease, the review states.

"If a glitazone is thought to be necessary, pioglitazone is probably safer, but should only be used as an adjunct to other hypoglycemic drugs where there is a contraindication or intolerance to metformin or sulphonylureas," the review states. "As with rosiglitazone, pioglitazone should not be used if there is any risk of heart failure and should probably be avoided in women at high risk of fracture."

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