Does roglitazone affect the progression of atherosclerosis?

January 01, 0001

Does roglitazone affect the progression of atherosclerosis?

It has been proposed that rosiglitazone could affect progression of atherosclerosis due to several of its chemical properties. These US and Canadian researchers performed the Assessment on the Prevention of Progression by Rosiglitazone on Atherosclerosis in Diabetes Patients With Cardiovascular History (APPROACH) study was undertaken to determine the effect of the thiazolidinedione rosiglitazone on coronary atherosclerosis compared with glipizide using intravascular ultrasound measurements. It was a randomized, double-blind, controlled 18-month study in 672 patients aged 30 to 80 years with established type 2 diabetes mellitus with atherosclerosis. The primary outcome was change in percent atheroma volume in the longest and straightest coronary artery that had not undergone intervention. Secondary outcomes included change in normalized total atheroma volume and change in total atheroma volume in the most diseased baseline 10-mm segment.

The researchers report: "Rosiglitazone did not significantly reduce the primary outcome of percent atheroma volume compared with glipizide (- 0.64%). The secondary outcome of normalized total atheroma volume was significantly reduced by rosiglitazone compared with glipizide (-5.1 mm3). However, no significant difference between groups was observed for the change in total atheroma volume within the most diseased baseline 10-mm segment (-1.7 mm3)."

The authors concluded: "Rosiglitazone did not significantly decrease the primary end point of progression of coronary atherosclerosis more than glipizide in patients with type 2 diabetes mellitus and coronary atherosclerosis."

There appears to be no additional benefit in atherosclerosis regarding the use of rosiglitazone beyond that achieved via glycemic control.

For the full abstract, click here.

Circulation 121:1176-1187, 16 March 2010 © 2010 American Heart Association
Effect of Rosiglitazone on Progression of Coronary Atherosclerosis in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease: The Assessment on the Prevention of Progression by Rosiglitazone on Atherosclerosis in Diabetes Patients With Cardiovascular History Trial. Hertzel C. Gerstein, Robert E. Ratner, Christopher P. Cannon, et al.. Correspondence to: H C Gerstein: [email protected]

Category: K. Circulatory, T. Endocrine/Metabolic/Nutritional. Keywords: rosiglitazone, diabetes, artheroma, atherosclerosis, APPROACH trial, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 7 May 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.