Bone density at the hip decreased by 2% in postmenopausal women taking rosiglitazone.
The insulin-sensitizing drugs
rosiglitazone and pioglitazone lower glucose in diabetic patients by activating
peroxisome proliferator-activated receptor-
(PPAR-). These receptors are also found in bone, and
animal research suggests that PPAR- activation may induce bone loss by
suppressing osteoblast function. In this randomized study from New Zealand,
researchers evaluated the effect of rosiglitazone on bone density in humans.
Fifty healthy postmenopausal women (mean age, 68) received either rosiglitazone (8 mg daily) or placebo for 14 weeks. Mean serum levels of two markers of bone turnover (osteocalcin and procollagen type I N-terminal propeptide) decreased significantly in the rosiglitazone group, but not in the placebo group. Moreover, at 14 weeks, mean bone density at the hip had decreased by about 2% in the rosiglitazone group but remained unchanged in the placebo group, a significant difference.
Comment: These findings suggest that rosiglitazone may accelerate bone loss in postmenopausal women. It will be important to determine whether the changes noted in this short-term study persist with longer-term treatment. The results are particularly worrisome because rosiglitazone was associated with a significant increase in fractures, compared with metformin and glyburide, in a recent 4-year diabetes study (N Engl J Med 2006; 355:2427). Until more data become available, clinicians should think about the possibility of accelerated bone loss when considering the use of rosiglitazone (and possibly pioglitazone).
— Allan S. Brett, MD
Published in Journal Watch General Medicine April 24, 2007
agonist rosiglitazone decreases bone
formation and bone mineral density in healthy postmenopausal women: A
randomized, controlled trial. J Clin Endocrinol Metab 2007 Apr;
92:1305-10.