The thiazolidinediones are the world's leading oral antidiabetes drugs, and doctors regularly prescribe them as a 'last-resort' drug when other medi-cations have failed to reduce blood glucose levels.
Back in 2000, Rezulin (troglita-zone), a thiazolidinedione developedby Warner Lambert, was withdrawn from the American market becauseit was found to be toxic to the liver.
At that time, two of its rivals-Actos (pioglitazone) and Avandia (rosiglita-zone)-were considered to be safer and were, therefore, allowed to stayon the market.
More recently, however, Avandia was found to dramatically increase the risk of bone fracture in women. And now, researchers have discovered that Actos produces exactly the same effect.
So, in addition to increasing the risk of broken bones and liver damage, thiazolidinediones also cause oedema, a condition that causes swelling or fluid retention in the limbs as well as in the lungs; they also increase the risk of heart failure (JAMA, 2007; 297: 1645).