Abstract
We thank Kolatkar for his interest in our manuscript.1Friedland S.N. Leong A. Filion K.B. et al.The cardiovascular effects of peroxisome proliferator-activated receptor agonists.Am J Med. 2012; 125: 126-133Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar He is correct that the clinical trial NCT00461058 was to include patients with class II heart failure and that ALECARDIO (NCT01042769) is a phase III trial. Nonetheless, the safety of peroxisome proliferator-activated receptor agonists remains controversial. Despite favorable effects on cardiovascular risk factors, rosiglitazone has been associated with an increased risk of myocardial infarction,2Nissen S.E. Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes.N Engl J Med. 2007; 356: 2457-2471Crossref PubMed Scopus (4072) Google Scholar and both rosiglitazone and pioglitazone have been associated with an increased risk of congestive heart failure.3Hernandez A.V. Usmani A. Rajamanickam A. Moheet A. Thiazolidinediones and risk of heart failure in patients with or at high risk of type 2 diabetes mellitus: a meta-analysis and meta-regression analysis of placebo-controlled randomized clinical trials.Am J Cardiovasc Drugs. 2011; 11: 115-128Crossref PubMed Scopus (162) Google Scholar With recent evidence also linking pioglitazone to an increased risk of bladder cancer,4Azoulay L. Yin H. Filion K.B. et al.The use of pioglitazone and the risk of bladder cancer in people with type 2 diabetes: nested case-control study.BMJ. 2012; 344: e3645Crossref PubMed Scopus (237) Google Scholar large multicenter, adequately powered trials are needed to thoroughly assess the safety of new peroxisome proliferator-activated receptor agonists before they enter the market to obtain a complete understanding of the overall risks and benefits associated with their use. We look forward to the availability of the results from ALECARDIO and other ongoing trials to clarify the safety and efficacy of aleglitazar. The Cardiovascular Effects of Peroxisome Proliferator-activated Receptor AgonistsThe American Journal of MedicineVol. 126Issue 3PreviewThe review by Friedland et al1 summarizes information regarding the cardiovascular effects of peroxisome proliferator-activated receptor agonists but includes inaccuracies related to aleglitazar, an investigational peroxisome proliferator-activated receptor-α/γ activator currently in clinical development. Full-Text PDF
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