Improvements in biomarkers and blood pressure have led researchers to suggest that rosiglitazone may offer cardiovascular benefits in postmenopausal women.
Previous studies have investigated the use of thiazolidinediones in patients with type 2 diabetes or hypertension. I-Chih Chen, MD, of the division of cardiology in the department of internal medicine at the National Cheng Kung University College of Medicine and Hospital and Tainan Municipal Hospital in Taiwan, and colleagues sought another route.
“To the best of our knowledge, no previous study has investigated the cardiovascular effects of TZDs and interplay of [hormone therapy] and TZD in nondiabetic postmenopausal women,” the researchers wrote.
In a prospective, double blind, randomized, placebo-controlled trial, Chen and colleagues enrolled 38 women aged at least 50 years who had undergone natural menopause for an average duration of more than 9 years. None of the patients had diabetes.
Patients receiving conjugated equine estrogen 0.625 mg per day and progestin 5 mg per day for at least 1 year were categorized into HT, and the remainder was not assigned to HT. Four patients received rosiglitazone 4 mg, and 20 patients took placebo daily for 12 weeks. Researchers collected blood samples and measurements of serum and plasma markers, besides measurements of global endothelial function by photoplethysmography.
Rosiglitazone significantly reduced leukocyte count by 10.1% (–19.4% to 1.8%; P=.04). Plasma levels of matrix metalloproteinase-9 were reduced by 70.5% (–86.7% to –53.3%; P=.04) when compared with baseline in both the rosiglitazone and placebo groups.
Rosiglitazone also prevented the progression of plasma levels of plasminogen activator inhibitor-1 (P=.05) and tissue plasminogen activator (P=.04) vs. the placebo group.
Concurrent HT treatment status did not interfere with the favorable effects of rosiglitazone, according to data. Patients who did not undergo HT experienced an increase in body weight and waist size, besides elevated plasma levels of total and LDL cholesterol, researchers said.
“Despite the controversial effects of TZDs on cardiovascular morbidity and mortality in women with type 2 diabetes, concurrent therapies of rosiglitazone and HT might still offer cardiovascular benefits without causing the unfavorable outcomes observed among nondiabeteic postmenopausal women,” the researchers wrote.
They suggest further large-scale studies aimed at the interplay of rosiglitazone and HT on antiatherothrombosis.
Disclosure: The researchers report no relevant financial disclosures