Fatal Hepatotoxicity Associated with Troglitazone
Authors: A. Vella, P. C. De Groen, S. F. Dinneen
Journal: Annals of Internal Medicine (1998)

Letters15 December 1998Fatal Hepatotoxicity Associated with TroglitazoneAdrian Vella, MD, Piet C. de Groen, MD, and Sean F. Dinneen, MD, MScAdrian Vella, MDMayo Clinic and Foundation; Rochester, MN 55905, Piet C. de Groen, MDMayo Clinic and Foundation; Rochester, MN 55905, and Sean F. Dinneen, MD, MScMayo Clinic and Foundation; Rochester, MN 55905Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-12-199812150-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read with interest Dr. Whitcomb's letter concerning, among other issues, hepatotoxicity associated with troglitazone [1]. According to experience in clinical trials to date, troglitazone-related hepatotoxicity is usually asymptomatic, mild, and reversible. However, clinical trial experience of drug toxicity often underestimates the prevalence and severity of adverse events observed during postmarketing use [2]. News of six deaths and one liver transplantation associated with troglitazone led to withdrawal of the product from the British market [3]. We describe another case of fatal hepatitis associated with troglitazone.An 85-year-old man with type 2 diabetes presented with severe hepatic dysfunction. ...References1. Whitcomb RW. Update in endocrinology [Letter]. Ann Intern Med. 1998; 128:871. Google Scholar2. de Groen PC, Lubbe DF, Hirsch LJ, Daifotis A, Stephenson W, Freed-holm D, et al. Esophagitis associated with the use of alendronate. N Engl J Med. 1996; 335:1016-21. Google Scholar3. Troglitazone suspended in UK after more adverse events. SCRIP. 1997; 2290:15. Google Scholar4. Schwartz S, Raskin P, Fonseca V, Graveline JF. Effect of troglitazone in insulin-treated patients with type II diabetes mellitus. N Engl J Med. 1998; 338:861-6. Google Scholar5. Physicians' Desk Reference. Montvale, NJ: Medical Economics Pr; 1998:2118-21. Google Scholar Author, Article, and Disclosure InformationAffiliations: Mayo Clinic and Foundation; Rochester, MN 55905 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByIntegrating in vitro testing and physiologically-based pharmacokinetic (PBPK) modelling for chemical liver toxicity assessment—A case study of troglitazoneWhat Is Pharmacoepidemiology?Thiazolidinedione drugs in the treatment of type 2 diabetes mellitus: past, present and futureHow to Avoid Being Surprised by Hepatotoxicity at the Final Stages of Drug Development and ApprovalDesign, Synthesis, Biological Activity and Molecular Dynamics Studies of Specific Protein Tyrosine Phosphatase 1B Inhibitors over SHP-2Hepatotoxicity of Cardiovascular and Antidiabetic DrugsWhat is Pharmacoepidemiology?The safety of thiazolidinedionesRole of Peroxisome Proliferator-Activated Receptor-.GAMMA. in Atherosclerosis - An Update -Improving the Reporting of Adverse Drug Reactions in the Hospital SettingImportant Elements for the Diagnosis of Drug-Induced Liver InjuryThe Role of Drug Metabolism in ToxicityDIABETES MELLITUSCurrent and novel therapies for the treatment of nonalcoholic steatohepatitisGene Expression Analysis of Troglitazone Reveals Its Impact on Multiple Pathways in Cell Culture: A Case for In Vitro Platforms Combined with Gene Expression Analysis for Early (Idiosyncratic) Toxicity ScreeningINVESTIGATION OF PROTEOMIC BIOMARKERS IN IN VIVO HEPATOTOXICITY STUDY OF RAT LIVER: TOXICITY DIFFERENTIATION IN HEPATOTOXICANTSCombination therapy using metformin or thiazolidinediones and insulin in the treatment of diabetes mellitusTroglitazone and liver injury: In search of answersAcarbose treatment in liver disease: Cognitive or glycemic control?Thiazolidinediones and InsulinHepatotoxicity of thiazolidinedionesHepatotoxicity of the thiazolidinedionesTroglitazone-induced liver failure: a case studyTroglitazone: the discovery and development of a novel therapy for the treatment of Type 2 diabetes mellitusTroglitazone enhances the hepatotoxicity of acetaminophen by inducing CYP3A in ratsEvaluation of Liver Function in Type 2 Diabetic Patients During Clinical Trials: Evidence that rosiglitazone does not cause hepatic dysfunction"Did This Drug Cause My Patient's Hepatitis?" and Related QuestionsDavid W. 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