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2002, Número 2

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Rev Endocrinol Nutr 2002; 10 (2)


Tiazolidinedionas. Beneficios y riesgos reales

Hernández-Jiménez S, Aguilar-Salinas CA, Gómez-Pérez FJ

Idioma: Español
Referencias bibliográficas: 179
Paginas: 69-76
Archivo PDF: 105.29 Kb.


RESUMEN

Las tiazolidinedionas constituyen un grupo nuevo de hipoglucemiantes orales, cuyo mecanismo de acción principal es el aumento de la sensibilidad a la insulina. En varios estudios se han encontrado efectos en el metabolismo de lípidos, en la diferenciación celular y en algunos factores de riesgo cardiovascular, por lo que se les han atribuido algunas ventajas sobre otros fármacos hipoglucemiantes. Sin embargo, aún existe controversia sobre sus beneficios y seguridad a largo plazo. En algunos países están permitidas como agentes de primera línea o se han restringido a terapia combinada con otros hipoglucemiantes. En este artículo se revisan algunos datos referentes a los beneficios y diferencias del espectro terapéutico de estos fármacos, en la prevención de la diabetes, su eficacia como tratamiento único o en combinación, y sus efectos adversos.


REFERENCIAS (EN ESTE ARTÍCULO)

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  109. Marx N, Schonbeck U, Lazar MA, Libby P, Plutzky J. Peroxisome proliferator-activated receptor gamma activators inhibit gene expression and migration in human vascular smooth muscle cells. Circ Res 1998; 83: 1097-1103.

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  112. Arima S, Kohagura K, Takeuchi K et al. Biphasic vasodilator action of troglitazone on the renal microcirculation. J Am Soc Nephrol 2002; 13(2): 342-9.

  113. Yamashita H, Nagai Y, Takamura T, Nohara E, Kobayashi Ki K. Thiazolidinedione derivatives ameliorate albuminuria in streptozotocin- induced diabetic spontaneous hypertensive rat. Metabolism 2002; 51(4): 403-8.

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  115. Goldstein BJ. Differentiating members of the thiazolidinedione class: a focus on efficacy. Diabetes Metab Res Rev 2002; 18 Suppl 2: S16-22.

  116. Temple R, Ellenberg SS. Placebo-Controlled Trials and Active- Control Trials in the Evaluation of New Treatments. Part 1: Ethical and Scientific Issues. Ann Intern Med 2000; 133: 455-63.

  117. Cavaghan MK, Ehrmann DA, Byrne MM, Polonsky S. Treatment with the oral antidiabetic agent troglitazone improves beta cell responses to glucose in subjects with impaired glucose tolerance. J Clin Invest 1997; 100: 530-7.

  118. Berkowitz K, Peters R, Kjos SL, Goico J, Marroquin A, Dunn ME, Xiang A, Azen S, Buchanan TA. Effect of troglitazone on insulin sensitivity and pancreatic B-cell function in women at high risk for non-insulin-dependent diabetes mellitus. Diabetes 1996; 45: 1572-1579.

  119. Azen SP, Berkowitz K, Kjos S, Peters R, Xiang A, Buchanan TA. TRIPOD: A randomized placebo-controlled trial of troglitazone in women with prior gestational diabetes mellitus. Control Clinical Trials 1998; 19:217-231.

  120. The Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Eng J Med 2002; 346: 393-403.

  121. Chu NV, Kong AP, Kim D, Armstrong D, Baxi S, Deutsch R et al. Differential effects of metformin and troglitazone on cardiovascular risk factors in patients with type 2 diabetes. Diabetes Care 2002; 25: 542-48.

  122. Kumar S, Boulton AJM, Beck-Nielsen H et al. Troglitazone, an insulin action enhancer, improves metabolic control in NIDDM patients. Diabetología 1996; 39: 701-9.

  123. Iwamoto I, Kosaka K, Kuzuya Y, Akanuma Y, Shigeta Y, Kaneko T. Effects of troglitazone: a new hypoglycemic agent in patients with NIDDM poorly controlled by diet therapy. Diabetes Care 1996; 19: 151-6.

  124. Antonucci T, Whitcomb R, McLain R, Lockwood D. Impaired glucose tolerance is normalized by treatment with the thiazolidinedione troglitazone. Diabetes Care 1997; 20: 188-93.

  125. Maggs DG, Buchanan TA, Burant Ch, Cline G, Gumbiner B, Hsueh WA. Metabolic Effects of Troglitazone Monotherapy in Type 2 Diabetes Mellitus. Ann Intern Med 1998; 128: 176-185.

  126. Subramaniam S. The emerging role of thiazolidinediones in the treatment of diabetes- mellitus and related disorders. Clin Exp Hypertens 1999; 21(1-2): 121-36.

  127. Inzucchi SE, Maggs DG, Spollett GR, Page SL, RifeFS, Walton V, Shulman GI. Efficacy and metabolic effects of metformin and troglitazone in type 2 diabetes. NEJM 1998; 338: 867-72.

  128. Fonseca V, Rosenstock J, Patwardhan R, Salzman A. Effect of metformin and rosiglitazone combination therapy in patients with type 2 diabetes mellitus: a randomized controlled trial. JAMA 2000; 283: 1695-1702.

  129. Raskin P, Rappaport EB, Cole ST, Yan Y, Patwardhan R, Freed MI. Rosiglitazone short-term monotherapy lowers fasting and post-prandial glucose in patients with type II diabetes. Diabetologia 2000; 43: 278-84.

  130. Gale EA. Lessons from the glitazones: a story of drug development. Lancet 2001; 357: 1870-75

  131. Kobayashi M, Iwata M, Haruta T. [Clinical evaluation of pioglitazone]. Nippon Rinsho 2000; 58(2): 395-400.

  132. Lawrence JM, Reckless JP. Pioglitazone. Int J Clin Pract 2000; 54(9): 614-8.

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