Thiazolidinediones and the risk of incident congestive heart failure among patients with type 2 diabetes mellitus

Filion, Kristian B.; Joseph, Lawrence; Boivin, Jean‐François; Suissa, Samy; Brophy, James M.

doi:10.1002/pds.2165

Cited by 21 publications

(12 citation statements)

References 29 publications

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“…Specifically, sulfonylureas carry a greater risk of hypoglycemia,27 whereas thiazolidinediones may increase the risk of peripheral edema, congestive heart failure,28 and bladder cancer,29 and GLP-1 agonists require subcutaneous injection and are associated with nausea 30. The presence of comorbidities and polypharmacy are additional important considerations and potentially limiting factors in the selection of antihyperglycemic therapy for older patients with diabetes 5…”

Section: Discussionmentioning

confidence: 99%

Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged ≥ 65 years) with inadequately controlled type 2 diabetes mellitus

Karyekar¹,

Ravichandran²,

Allen³

et al. 2013

CIA

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PurposeTo assess safety and efficacy of saxagliptin in older patients with type 2 diabetes mellitus (T2DM).Patients and methodsThis was a post hoc analysis of pooled data from older patients (≥65 years of age) from five 24-week phase III trials: three studies of saxagliptin versus placebo as an add-on therapy to metformin, glyburide, or a thiazolidinedione; and two studies of saxagliptin versus placebo as monotherapy in drug-naïve patients. Separate analyses were conducted on one study of initial combination therapy with saxagliptin plus metformin versus metformin monotherapy in drug-naïve patients. The safety analysis population for the five-study pool included 428 patients ≥ 65 years of age with baseline glycated hemoglobin (HbA1c) 7.0% to 10.5% who received saxagliptin 2.5 or 5 mg or placebo, and for the study of initial combination therapy included 69 patients ≥ 65 years of age with baseline HbA1c 8.0% to 12.0% who received saxagliptin 5 mg in combination with metformin or metformin monotherapy. The primary efficacy endpoint was change from baseline HbA1c.ResultsIn the five-study pool, the differences in the adjusted mean change from baseline HbA1c among older patients receiving saxagliptin versus placebo were −0.60% (95% confidence interval [CI], −0.99% to −0.21%) for saxagliptin 2.5 mg and −0.55% (−0.97% to −0.14%) for saxagliptin 5 mg; in the initial combination study, the difference was −1.22% (−2.27% to −0.17%) among older patients receiving saxagliptin 5 mg plus metformin versus metformin monotherapy. The results were generally similar in older and younger patients. Saxagliptin was well tolerated; the incidence and types of adverse events were similar for saxagliptin and comparators. Hypoglycemia was reported in 3.0% to 9.4% of patients receiving saxagliptin (0%–8.0% for comparators) and was confirmed (finger stick glucose ≤ 50 mg/dL, with associated symptoms) in 0% to 0.7% (0%–0.7% for comparators); hypoglycemic episodes did not vary by age category and did not require medical intervention.ConclusionSaxagliptin was effective and well tolerated, with a low risk of hypoglycemia, when used as monotherapy, add-on therapy, or initial combination therapy with metformin in older patients with T2DM.

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Section: Discussionmentioning

confidence: 99%

Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged ≥ 65 years) with inadequately controlled type 2 diabetes mellitus

Karyekar¹,

Ravichandran²,

Allen³

et al. 2013

CIA

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“…Thioglitazones, some of which are currently used to treat diabetes, are thought to be able to manipulate the insulin resistance pathway and to have the potential to be an effective therapy for uremic cardiomyopathy. It should be noted, however, that some thioglitazones have been associated with increased risk of congestive heart failure, which might complicate their role in the treatment of this disease …”

Section: Investigational Therapies For Uremic Cardiomyopathymentioning

confidence: 99%

“…It should be noted, however, that some thioglitazones have been associated with increased risk of congestive heart failure, which might complicate their role in the treatment of this disease. 69,70 CONCLUSIONS Uremic cardiomyopathy is responsible for high morbidity and mortality rates among patients with CKD or ESRD, but an early start of hemodialysis may halt its progression. Particularly nonconventional hemodialysis, such as frequent hemodialysis, appears to have an advantage over conventional hemodialysis.…”

Section: Investigational Therapies For Uremic Cardiomyopathymentioning

confidence: 99%

Uremic Cardiomyopathy: An Underdiagnosed Disease

Alhaj

Rahman

et al. 2013

Congestive Heart Failure

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Uremic cardiomyopathy is responsible for high morbidity and mortality rates among patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD); however, the early implementation of hemodialysis may halt its progression. Nonconventional hemodialysis, such as frequent hemodialysis, appears to have an advantage over conventional hemodialysis. Kidney transplantation has been shown to reverse uremic cardiomyopathy and to confer a significant survival advantage over hemodialysis. Targeting future therapies at the underlying cellular mechanisms of uremic cardiomyopathy may finally start to reduce the burden of uremic cardiomyopathy in the CKD and ESRD population.

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“…Данные нескольких метаанализов также подтвердили увеличение частоты возникновения СН (новые случаи) и ухудшение симптомов уже имеющейся СН у пациентов, получавших глитазоны [17][18][19][20].…”

Section: лекарственные средства прием которых ассоциирован с развитиunclassified

Drug-Induced Heart Failure (Part 1: The Urgency of the Problem, the Prevalence, the Effect of Certain Groups of Drugs on the Risk of Development/Progression Heart Failure)

Остроумова

Васильевна

2020

Bezopasnost' i risk farmakoterapii

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1 Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации, ул. Баррикадная, д. 2/1, стр. 1, Москва, 125993, Российская Федерация 2 Федеральное государственное бюджетное образовательное учреждение высшего образования «Московский государственный медико-стоматологический университет им. А. И. Евдокимова» Министерства здравоохранения Российской Федерации, ул. Делегатская, д. 20/1, Москва, 127423, Российская ФедерацияРезюме. Сердечная недостаточность, несмотря на все достижения современной медицины, остается одним из наиболее распространенных, тяжело текущих и прогностически неблагоприятных состояний, требующих пристального внимания медицинской общественности. Разнообразие клинической картины в совокупности с большим количеством заболеваний, сопутствующих сердечной недостаточности, сочетается с достаточно сложной схемой фармакотерапии, в абсолютном большинстве случаев включающей несколько препаратов. Некоторые классы лекарственных средств способны провоцировать возникновение/прогрессирование сердечной недостаточности у лиц с дисфункцией левого желудочка, а также способствовать ее развитию у пациентов без сопутствующих заболеваний сердечно-сосудистой системы. Цель работы: анализ и систематизация данных о факторах риска развития лекарственно-индуцированной сердечной недостаточности и ее распространенности при применении различных групп лекарственных средств. Установлено, что наиболее часто лекарственно-индуцированная сердечная недостаточность развивается на фоне использования блокаторов кальциевых каналов (верапамил, дилтиазем, нифедипин), бета-блокаторов (пропранолол), антиаритмических (дизопирамид, дронедарон, лидокаин, лоркаинид, мексилетин, морицизин, пропафенон, токаинид, флекаинид, энкаинид), гипогликемических препаратов (росиглитазон, пиоглитазон, саксаглиптин), антрациклинов (доксорубицин, эпирубицин) и других противоопухолевых средств (бевацизумаб, инфликсимаб, трастузумаб), нестероидных противовоспалительных средств (диклофенак, ибупрофен, целекоксиб, рофекоксиб и др.). Предполагается, что эта патология развивается у небольшого числа пациентов, в основном уже имеющих дисфункцию левого желудочка. Тем не менее воздействие лекарственных средств следует рассматривать как одну из потенциально возможных и предотвратимых причин развития/прогрессирования сердечной недостаточности. Осведомленность медицинских работников о потенциальном неблагоприятном действии на сердечную деятельность отдельных представителей или целых фармакологических групп лекарственных средств, особенно у пациентов с имеющимся нарушением функции левого желудочка, может способствовать своевременной диагностике и профилактике лекарственно-индуцированной сердечной недостаточности. Ключевые слова: сердечная недостаточность; лекарственно-индуцированная сердечная недостаточность; блокаторы кальциевых каналов; бета-блокаторы; антиаритмические препараты; гипогликемические пре...

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Thiazolidinediones and the risk of incident congestive heart failure among patients with type 2 diabetes mellitus

Abstract: Given the totality of the evidence from this and previous studies, the probability of an increased risk for CHF with these agents remains high. However, any increase in CHF risk associated with TZDs may be lower than previously reported.

Cited by 21 publications

References 29 publications

Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged ≥ 65 years) with inadequately controlled type 2 diabetes mellitus

Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged ≥ 65 years) with inadequately controlled type 2 diabetes mellitus

Uremic Cardiomyopathy: An Underdiagnosed Disease

Drug-Induced Heart Failure (Part 1: The Urgency of the Problem, the Prevalence, the Effect of Certain Groups of Drugs on the Risk of Development/Progression Heart Failure)

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Thiazolidinediones and the risk of incident congestive heart failure among patients with type 2 diabetes mellitus

Abstract: Given the totality of the evidence from this and previous studies, the probability of an increased risk for CHF with these agents remains high. However, any increase in CHF risk associated with TZDs may be lower than previously reported.

Cited by 21 publications

References 29 publications

Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged &ge; 65 years) with inadequately controlled type 2 diabetes mellitus

Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged &ge; 65 years) with inadequately controlled type 2 diabetes mellitus

Uremic Cardiomyopathy: An Underdiagnosed Disease

Drug-Induced Heart Failure (Part 1: The Urgency of the Problem, the Prevalence, the Effect of Certain Groups of Drugs on the Risk of Development/Progression Heart Failure)

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Product

Resources

About

Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged ≥ 65 years) with inadequately controlled type 2 diabetes mellitus

Tolerability and efficacy of glycemic control with saxagliptin in older patients (aged ≥ 65 years) with inadequately controlled type 2 diabetes mellitus