Long-Term Pioglitazone Treatment for Patients With Nonalcoholic Steatohepatitis
Authors: Stuart K. Sutton
Journal: Annals of Internal Medicine (2017)

Letters7 February 2017Long-Term Pioglitazone Treatment for Patients With Nonalcoholic SteatohepatitisStuart K. Sutton, MDStuart K. Sutton, MDFrom Eastern Virginia Medical School, Norfolk, Virginia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0627 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read Cusi and colleagues' (1) article about the benefits of pioglitazone in the management of nonalcoholic steatohepatitis in early or overt type 2 diabetes mellitus (T2DM) with interest yet also a sense of discouragement. As clinicians, we are frequently faced with patients who are understandably concerned about this liver condition, yet we have little to offer beyond advice on lifestyle measures. Although their research showed impressive benefit with the use of pioglitazone, the legal climate surrounding this drug, if not the entire class to which it belongs, is virtually certain to limit if not prevent its ...References1. Cusi K, Orsak B, Bril F, Lomonaco R, Hecht J, Ortiz-Lopez C, et al. Long-term pioglitazone treatment for patients with nonalcoholic steatohepatitis and prediabetes or type 2 diabetes mellitus. A randomized trial. Ann Intern Med. 2016;165:305-15. [PMID: 27322798]. doi:10.7326/M15-1774 LinkGoogle Scholar2. Lewis JD, Habel LA, Quesenberry CP, Strom BL, Peng T, Hedderson MM, et al. Pioglitazone use and risk of bladder cancer and other common cancers in persons with diabetes. JAMA. 2015;314:265-77. [PMID: 26197187] doi:10.1001/jama.2015.7996 CrossrefMedlineGoogle Scholar3. Levin D, Bell S, Sund R, Hartikainen SA, Tuomilehto J, Pukkala E, et al; Scottish Diabetes Research Network Epidemiology Group. Pioglitazone and bladder cancer risk: a multipopulation pooled, cumulative exposure analysis. Diabetologia. 2015;58:493-504. [PMID: 25481707] doi:10.1007/s00125-014-3456-9 CrossrefMedlineGoogle Scholar4. Ryder RE. Pioglitazone has a dubious bladder cancer risk but an undoubted cardiovascular benefit. Diabet Med. 2015;32:305-13. [PMID: 25472014] doi:10.1111/dme.12627 CrossrefMedlineGoogle Scholar5. Davidson MB. Pioglitazone (Actos) and bladder cancer: legal system triumphs over the evidence. J Diabetes Complications. 2016;30:981-5. [PMID: 27133452] doi:10.1016/j.jdiacomp.2016.04.004 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Eastern Virginia Medical School, Norfolk, Virginia.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L16-0627. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLong-Term Pioglitazone Treatment for Patients With Nonalcoholic Steatohepatitis and Prediabetes or Type 2 Diabetes Mellitus Kenneth Cusi , Beverly Orsak , Fernando Bril , Romina Lomonaco , Joan Hecht , Carolina Ortiz-Lopez , Fermin Tio , Jean Hardies , Celia Darland , Nicolas Musi , Amy Webb , and Paola Portillo-Sanchez Long-Term Pioglitazone Treatment for Patients With Nonalcoholic Steatohepatitis James A. Thomas , Rohit Gupta , and Guruprasad P. Aithal Long-Term Pioglitazone Treatment for Patients With Nonalcoholic Steatohepatitis Fernando Bril and Kenneth Cusi Metrics 7 February 2017Volume 166, Issue 3Page: 229KeywordsBladder cancerCancer treatmentDrugsHereditary nonpolyposis colorectal cancerInternetLiverNonalcoholic steatohepatitisPancreatic cancerPatientsType 2 diabetes ePublished: 7 February 2017 Issue Published: 7 February 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...