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Diseases of the heart and blood vessels account for approximately 70% of all mortality in people with diabetes. Compared to their non‐diabetic counterparts the relative risk of mortality caused by disorders of the heart and blood vessels is two to three for men and three to four for women with diabetes. Type 2 diabetes is mainly characterised by a reduced ability of the hormone insulin to stimulate glucose uptake in body fat and muscles (insulin resistance) and affects most people suffering from diabetes. Several medications are on the market to treat diabetes, amongst them rosiglitazone as a member of the 'glitazones' reduced risk markers for diseases of the heart and blood vessels. Since the two biggest trials in people with type 2 diabetes showed that improved blood glucose alone is not enough to reduce the risk of the above mentioned diseases we looked for longer‐term studies investigating 24 weeks as a minimum of rosiglitazone treatment on patient‐oriented outcomes. As patient‐oriented outcomes we defined mortality, complications of diabetes, side effects of the medication, health‐related quality of life, costs and metabolic control (lowering of blood glucose to near normal levels).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 18, 2007

Bibliographic details: Yao Y, Zhang TY, Yang F, Guo WY, Zhang QQ, Yu YQ.  [Meta-analysis on effect of rosiglitazone in treatment of Alzheimer's disease]. Journal of Jilin University (Medicine Edition) 2012; 38(2): 296-302

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

The aim of this review was to evaluate the use of pioglitazone and rosiglitazone, in terms of both clinical and cost-effectiveness in the treatment of type 2 diabetes.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2004

Bibliographic details: Du Q, Yang S, Wu B, Han P.  Rosiglitazone versus metformin for polycystic ovary syndrome: a systematic review. Chinese Journal of Evidence-Based Medicine 2011; 11(9): 1021-1026 Available from: http://www.cjebm.org.cn/oa/DArticle.aspx?type=view&id=201109008

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Bibliographic details: Boucher M, McAuley L, Brown A, Keely E, Skidmore B.  Comparative clinical and budget evaluations of rosiglitazone and pioglitazone with other anti-diabetic agents. Ottawa, ON, Canada: Canadian Coordinating Office for Health Technology Assessment (CCOHTA). Technology Overview; 9. 2003 Available from: http://www.cadth.ca/index.php/en/hta/reports-publications

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Bibliographic details: Fang ZL, Shen G, Hu SL, Xu TJ, Chen Y, Wu L, Xu WP.  Rosiglitazone in treating type 2 diabetes mellitus with essential hypertension patients: a meta-analysis. Chinese Journal of Evidence-Based Medicine 2011; 11(9): 1012-1020

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

BACKGROUND: The difference of cardiovascular effects between rosiglitazone and pioglitazone treatment for diabetic patients has not been thoroughly studied. We performed a meta-analysis to compare the risk of cardiovascular adverse effects in patients with type 2 diabetes treated with rosiglitazone compared to pioglitazone.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

OBJECTIVES: To evaluate the use of pioglitazone and rosiglitazone, in terms of both clinical and cost-effectiveness in the treatment of type 2 diabetes.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

This review of randomised trials concluded that rosiglitazone use for at least 12 months is associated with a significantly increased risk of myocardial infarction and heart failure, but not cardiovascular mortality, in patients with impaired glucose tolerance or type 2 diabetes. These conclusions appear appropriate given the evidence presented.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

This review, which included a very large number of patients, concluded that rosiglitazone treatment increased the risk of myocardial infarction, but not of cardiovascular or all-cause mortality, compared with placebo or alternative interventions. Despite a lack of validity assessment and poor reporting of some aspects of the review process, this conclusion is probably reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

The authors concluded that rosiglitazone appeared to be safe with respect to the risk of incidence of cancer, but that further studies were needed to confirm a possible protective effect. Given potential for bias in the review, issues with the statistical analysis and uncertain quality of the included studies, the authors' conclusion should be interpreted with caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

This review assessed the cardiovascular risk of rosiglitazone and found it to be associated with increased risk of heart failure, but not increased risk of myocardial infarction or cardiovascular mortality. Issues with potential publication bias and study quality mean that the authors' conclusion should be interpreted with some caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

The aims of this research were the comparative benefit assessments of long-term treatment with pioglitazone or rosiglitazone vs. placebo, pioglitazone or rosiglitazone vs. another glucose-lowering drug or non-drug intervention, pioglitazone vs. rosiglitazone, in each case as monotherapy or in combination with another glucose-lowering therapy, in patients with diabetes mellitus type 2 treated within the framework of the valid drug approval criteria.

Institute for Quality and Efficiency in Health Care: Executive Summaries [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 26, 2008

How do newer drugs for diabetes compare in lowering blood sugar levels?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: May 16, 2011

How do thiazolidinediones compare in lowering blood sugar levels?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: September 1, 2009

To compare the effectiveness and adverse event profiles of amylin agonists, DPP-4 inhibitors, incretin mimetics, TZDs, and certain combination products for people with type 2 diabetes and for people with type 1 diabetes for pramlintide only.

Drug Class Reviews - Oregon Health & Science University.

Version: February 2011

Dementia is a global healthcare concern. Type 2 diabetes mellitus — a form of diabetes which becomes commoner with older age — increases the risk of developing dementia. Type 1 diabetes, which typically begins earlier in life, is always treated with insulin; but there are a variety of different ways of treating Type 2 diabetes, including lifestyle changes and different medications. We wanted to find out if some ways of treating Type 2 diabetes were better than others in terms of preventing either dementia or less serious decline in cognition (memory and other thinking skills).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: June 15, 2017

This summary covers the research on the benefits and possible side effects of medicines to lower or control your blood sugar. It will help you talk with your doctor or other health care professional to decide which medicines are best for you.

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: June 30, 2011

There are 2 thiazolidinediones approved for prescription use in the United States, rosiglitazone maleate (Avandia™) and pioglitazone hydrochloride (Actos®). Both drugs are approved by the United States Food and Drug Administration for use in adults for the treatment of type 2 diabetes, either as monotherapy or in combination with insulin, metformin, or sulfonylurea when diet, exercise, and a single agent does not result in adequate glycemic control. Neither drug is currently approved for use in prediabetes or the metabolic syndrome. The objective of this review was to compare thiazolidinediones in the treatment of type 2 diabetes, prediabetes, and the metabolic syndrome.

Drug Class Reviews - Oregon Health & Science University.

Version: August 2008

In August 2010, the Canadian Agency for Drugs and Technologies in Health (CADTH) published an Optimal Therapy Report which assessed the clinical and cost-effectiveness of second-line therapies for patients with type 2 diabetes inadequately controlled on metformin. The results from the CADTH review indicated that there were no apparent differences in efficacy across drug classes, and that sulfonylureas were the most cost-effective treatment option. Based on these analyses, the Canadian Optimal Medication Prescribing and Utilization Service (COMPUS) Expert Review Committee (CERC) recommended that most patients requiring a second treatment after metformin should be prescribed a sulfonylurea. CADTH followed this report with a Therapeutic Review which examined the evidence for third-line treatment options for adults with type 2 diabetes inadequately controlled on metformin and a sulfonylurea. The results demonstrated that insulins (basal, biphasic, bolus), dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) analogues, and thiazolidinediones (TZDs) all produced statistically significant reductions in hemoglobin A1C in combination with metformin and a sulphonylurea. Meglitinides and alpha-glucosidase inhibitors, however, did not. The addition of insulin neutral protamine Hagedorn (NPH) to metformin plus a sulfonylurea was associated with the most favourable cost-effectiveness estimates. CADTH’s Therapeutic Review Panel (TRP) recommended that, for most adults with type 2 diabetes inadequately controlled on metformin and a sulfonylurea, insulin NPH should be added as the third-line agent. Long-acting insulin analogues at prices similar to insulin NPH were also considered an option for patients inadequately controlled on metformin and a sulfonylurea.

CADTH Optimal Use Report - Canadian Agency for Drugs and Technologies in Health.

Version: November 2012

Systematic Reviews in PubMed

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Systematic Review Methods in PubMed

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