Molecular structure of troglitazone
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Troglitazone

Troglitazone (Rezulin®, Resulin® or Romozin®) is a member of the drug class of the thiazolidinediones. It was introduced in the late 1990s but turned out to be associated with an idiosyncratic reaction leading to drug-induced hepatitis. It was withdrawn from the USA market on 21 March 2000, and from other markets soon afterwards. more...

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Troglitazone, like the other thiazolidinediones (pioglitazone and rosiglitazone), works by activating PPARs (peroxisome proliferator-activated receptors). Troglitazone is a ligand to both PPARα and - more strongly - PPARγ. Troglitazone also contains an α-tocopheroyl moiety, potentially giving it vitamin E-like activity in addition to its PPAR activation. It has been shown (Aljada et al) to reduce inflammation: troglitazone use was associated with a decrease of nuclear factor kappa-B (NFκB) and a concomitant increase in its inhibitor (IκB). NFκB is an important cellular transcription regulator for the immune response.

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Troglitazone Has Been Withdrawn from the Market - Rezulin
From American Family Physician, 4/15/00 by Rosemarie Sweeney

After a request from the FDA on March 21, the manufacturer of troglitazone (Rezulin), a drug used in the treatment of type 2 diabetes mellitus (formerly known as non-insulin-dependent diabetes mellitus) agreed to remove the product from the market. The FDA took this action after its review of recent safety data on troglitazone and two similar drugs, rosiglitazone (Avandia) and pioglitazone (Actos), showed that troglitazone is more toxic to the liver than the other two drugs. To date, data show that rosiglitazone and pioglitazone offer the same benefits as troglitazone without the same risk. At least 61 deaths have been linked to troglitazone. "When considered as a whole, the pre-marketing clinical data and post-marketing safety data from Rezulin as compared to similar, alternative diabetes drugs indicate that continued use of Rezulin now poses an unacceptable risk to patients," said Dr. Janet Woodcock, director of FDA's Center for Drug Evaluation and Research. "We are now confident that patients have safer alternatives in this important class of diabetes drugs," she noted.

COPYRIGHT 2000 American Academy of Family Physicians
COPYRIGHT 2000 Gale Group

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