Rosiglitazone vs. Pioglitazone — What Are the Odds?

The two thiazolidinediones available to treat type 2 diabetes in the U.S. are pioglitazone (Actos) and rosiglitazone (Avandia). Rosiglitazone raises risk for ischemic cardiovascular events, and both drugs raise risk for congestive heart failure (CHF). In a meta-analysis of 16 observational studies involving 810,000 patients (mean age, 54–76), investigators compared the effects of pioglitazone and rosiglitazone on risks for myocardial infarction (MI), CHF, and overall mortality in patients with type 2 diabetes.

Average follow-up ranged from 105 days to 7.1 years. Compared with pioglitazone, rosiglitazone was associated with significantly increased odds for MI (odds ratio, 1.16), CHF (OR, 1.22), and mortality (OR, 1.14).