PubMed ID:
10749332
Public Release Type:
Journal
Publication Year: 2000
Affiliation: Department of Medicine, University of California, San Francisco, 94143-0538, USA.
DOI:
https://doi.org/10.1023/a:1005405526283
Authors:
Lee WM,
Bass NM,
Chow H,
Davern TJ,
Freise C,
Masharani U,
Murphy EJ,
Shakil AO,
Shick L
Studies:
Acute Liver Failure Study Group: Adult Acute Liver Failure Study
The three reported cases demonstrate that troglitazone is an idiosyncratic hepatotoxin that can lead to irreversible liver injury. Thus, troglitazone should be prescribed with caution and should not be used as a first-line agent in the treatment of type II DM when potentially less toxic alternatives are available. It remains to be seen whether the hepatotoxicity associated with troglitazone is a drug-class effect or specific to troglitazone. Other thiazolidinediones currently in clinical trials may be able to provide the therapeutic benefits of troglitazone without significant hepatotoxicity. If troglitazone is used, frequent monitoring of serum aminotransferases and symptoms is mandatory. However, as illustrated by these and other cases reported to date, the onset of troglitazone-induced liver injury is insidious and temporally variable. Thus, the value of close monitoring and when, if ever, it is safe to stop such monitoring are currently unclear.