Have the Risks of Rosiglitazone Been Exaggerated?
Nissen and Wolski recently reported a meta-analysis of 42 clinical trials of 27,847 subjects that ignited a firestorm of controversy by claiming that treatment with rosiglitazone (Avandia, GlaxoSmithKline [GSK]), a widely prescribed PPARγ agonist, was associated with a "... worrisome... " 43% greater risk of myocardial infarction (MI; p = 0.03) and a 64% greater risk of cardiovascular death (CVD; p = 0.06). A number of criticisms have been raised against this analysis with many pointing to the initial conclusions as premature, indefinite or even alarmist. We herein attempt to further explicate these issues, and offer suggestions for potential solutions.