Severe Hypo-α-Lipoproteinemia During Treatment With Rosiglitazone
- Anita Sarker, MB, BS, MSC1,
- Robert K. Semple, MA, MB, BCHIR12,
- Sean F. Dinneen, MD2,
- Stephen O’Rahilly, MD12 and
- Steven C. Martin, MD, DRMEDSC13
- 1Department of Clinical Biochemistry, Addenbrooke’s Hospital, Cambridge, U.K.
- 2Department of Diabetes and Endocrinology, Addenbrooke’s Hospital, Cambridge, U.K.
- 3Department of Clinical Chemistry, West Suffolk Hospital, Bury St. Edmunds, Suffolk, U.K.
- Address correspondence and reprint requests to Dr. Anita Sarker, Box 232, Addenbrooke’s Hospital, Cambridge CB2 2QR, U.K. E-mail: as461{at}cam.ac.uk
Abstract
Thiazolidinedione drugs are in widespread use for the treatment of type 2 diabetes. In addition to improving insulin sensitivity, they generally result in a modest elevation of plasma HDL cholesterol. We report three patients, all of whom had preexisting diabetic dyslipidemia, who showed a profound reduction in plasma HDL cholesterol and apolipoprotein AI levels soon after the initiation of rosiglitazone therapy. In all three patients, HDL cholesterol levels returned to normal following drug withdrawal. The fact that this phenomenon was not seen in >1,400 patients studied in clinical trials indicates that it is likely to be rare and idiosyncratic. Until the frequency of this adverse reaction is clearer, it would seem advisable to ensure that plasma HDL cholesterol is documented before and rechecked after commencement of thiazolidinedione therapy.
Footnotes
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A.S. and R.K.S. contributed equally to this work.
S.F.D. has received honoraria from GlaxoSmithKline, Pfizer, Aventis, and Novo Nordisk for speaking engagements and serves on an advisory board for GlaxoSmithKline Pharmaceuticals. S.O. is a member of the U.K. GlaxoSmithKline rosiglitazone advisory board.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted August 2, 2004.
- Received April 27, 2004.
- DIABETES CARE
