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Postmenopausal women benefited from diabetes drug rosiglitazone
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Improvements in biomarkers and blood pressure have led researchers to suggest that the type 2 diabetes drug rosiglitazone may offer cardiovascular benefits in postmenopausal women.
Previous studies have investigated the use of thiazolidinediones (TZDs) in patients with type 2 diabetes or hypertension.
I-Chih Chen, MD, of the division of cardiology in the department of internal medicine at the National Cheng Kung University College of Medicine and Hospital and Tainan Municipal Hospital in Taiwan, and colleagues sought another route.
“To the best of our knowledge, no previous study has investigated the cardiovascular effects of TZDs and interplay of [hormone therapy] and TZD in nondiabetic postmenopausal women,” the researchers wrote.
In a prospective, double blind, randomized, placebo-controlled trial, Chen and colleagues enrolled 38 women aged at least 50 years who had undergone natural menopause for an average duration of more than 9 years. None of the patients had diabetes.
Patients receiving conjugated equine estrogen 0.625 mg per day and progestin 5 mg per day for at least 1 year were categorized into hormone therapy. The remainder of patients were not assigned to hormone therapy.
Four patients received rosiglitazone 4 mg, and 20 patients took placebo daily for 12 weeks. Researchers collected blood samples and measurements of serum and plasma markers, besides measurements of global endothelial function by photoplethysmography.
Rosiglitazone significantly reduced leukocyte count by 10.1% (–19.4% to 1.8%; P=.04). Plasma levels of matrix metalloproteinase-9 were reduced by 70.5% (–86.7% to –53.3%; P=.04) when compared with baseline in both the rosiglitazone and placebo groups.
Rosiglitazone also prevented the progression of plasma levels of plasminogen activator inhibitor-1 (P=.05) and tissue plasminogen activator (P=.04) vs. the placebo group.
Concurrent hormone therapy treatment status did not interfere with the favorable effects of rosiglitazone, according to data. Patients who did not undergo hormone therapy experienced an increase in body weight and waist size, besides elevated plasma levels of total and LDL cholesterol, researchers said.
“Despite the controversial effects of TZDs on cardiovascular morbidity and mortality in women with type 2 diabetes, concurrent therapies of rosiglitazone and hormone therapy might still offer cardiovascular benefits without causing the unfavorable outcomes observed among nondiabetic postmenopausal women,” the researchers wrote.
The researchers suggest further large-scale studies evaluate the interplay of rosiglitazone and hormone therapy on anti-atherothrombosis.
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