Mostly true Certainty of evidence: moderate provisional C-ODD-09

Rosiglitazone (Avandia) raised myocardial infarction risk by 43% (Nissen meta-analysis), leading to an FDA black-box warning, and RECORD confirmed a doubling of heart failure.

Conclusion: Heart-failure harm confirmed; heart-attack harm suggested but not settled.

Original statement

روزيغليتازون (أفانديا) رفع خطر احتشاء القلب 43% في تحليل نيسن التلوي لاثنتين وأربعين تجربة، فأصدرت FDA تحذيرها بالحدود السوداء، ثم جاءت تجربة RECORD لتؤكد مضاعفة خطر فشل القلب (HR 2.10).

verbatim according to source. Translation by the project; the Arabic wording is authoritative.

Translation

Rosiglitazone (Avandia) raised myocardial infarction risk by 43% (Nissen meta-analysis), leading to an FDA black-box warning, and RECORD confirmed a doubling of heart failure.

Origin

Source status
Archive editors
Attribution
Archive editors (not Elawady)
Origin
https://eltayebat.com/rule/oral-diabetes-drugs/
Attribution uncertainty
Editorial narrative and study selection written by the archive operators.
Claimed health effect

MI, heart failure

Population concerned

Type 2 diabetes

Geographic restriction by Elawady

none found

Scientific assessment

Mostly true – Correct at its core, but with limitations or minor inaccuracies.

Certainty of evidence: moderate – Further research may still affect the assessment.

1. What was claimed?

Rosiglitazone raises MI and doubles heart failure.

2. What is demonstrably correct?

Nissen & Wolski: MI OR 1.43 (1.03-1.98), CV death OR 1.64 (0.98-2.74, borderline) (A-ODD-01). RECORD: heart failure HR 2.10 (1.35-3.27), more fractures in women (A-ODD-02, I-ODD-13).

3. What is wrong or exaggerated?

RECORD found rosiglitazone non-inferior for cardiovascular hospitalisation or death (HR 0.99) and MI HR 1.14 (0.80-1.63), i.e. 'inconclusive' (I-ODD-13). Nissen's meta-analysis lacked patient-level data (A-ODD-01). The rosiglitazone history is an example of drug safety monitoring working, not proof that all diabetes drugs are harmful.

4. What remains unclear?

Exact MI risk.

5. Which studies support it?

A-ODD-01, A-ODD-02, I-ODD-13 (heart failure).

6. Which studies contradict it?

I-ODD-13 (MI inconclusive, overall CV non-inferior).

7. What applies to Germany and Europe?

Not available in the EU since 2010 (to be verified).

8. What is known about Egypt?

Availability in Egypt not verified.

9. What practical conclusion is appropriate?

Thiazolidinediones should not be used in heart failure; the MI question for rosiglitazone was never fully settled.

Assessment details

Rationale for certainty of evidence

Heart-failure risk confirmed in a randomised trial (high certainty). MI signal from a meta-analysis of short trials (OR 1.43, borderline CI) was 'inconclusive' in RECORD; the archive's wording overstates the MI finding as established.

Source quality

Archive editorial citing meta-analysis and RCT.

Regional transferability

Rosiglitazone is no longer marketed in the EU (suspended by EMA in 2010; not fetched; verified: false).

Regional scope of the claim
general (biological/medical)
Last reviewed
25 October 2026 provisional

In plain language

Rosiglitazone clearly increases the risk of heart failure, as a large trial confirmed. Whether it also increases heart attacks remained uncertain. The drug was withdrawn from the European market. Its story shows why drug safety is monitored after approval.

Studies on this claim

Studies supporting the claim (2)

  • Rosiglitazone and heart attacks: pooled trials

    Nissen SE et al.. N Engl J Med 2007 · PMID 17517853 · DOI 10.1056/NEJMoa072761
    Meta-analysiscited by the Tayebat archiveabstract only checked★ key study

    Pooling 42 trials suggested 43% more heart attacks; the increase in heart deaths was not statistically certain.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Effect of rosiglitazone on MI and CV death

    How was the study done?

    Meta-analysis of 42 randomised trials (fixed effects, trial-level data)

    How many people, animals or samples were studied?

    42 trials (116 screened); Type 2 diabetes in trials >24 weeks, mean age 56, HbA1c 8.2%

    What was actually found?

    MI OR 1.43; CV death OR 1.64 (n.s.).

    How large was the observed effect?

    OR 1.43 (1.03-1.98)

    What do the results mean in everyday life?

    A real warning signal that changed drug regulation.

    What are the study's limitations?

    No patient-level data; Rare events, fixed-effect model; Short trials not designed for CV outcomes

    What does it say about Elawady's specific claim?

    Supports C-ODD-09, C-ODD-05.

    Do the results apply to Germany and Europe?

    Rosiglitazone no longer marketed in EU (not verified).

    What can explicitly not be concluded from this study?

    That all diabetes drugs raise heart attacks.

    Scientific details →

  • Rosiglitazone and heart failure (RECORD)

    Komajda M et al.. Eur Heart J 2010 · PMID 20118174 · DOI 10.1093/eurheartj/ehp604
    Randomised controlled trialcited by the Tayebat archivefull text checked

    Heart failure doubled with rosiglitazone (2.6 extra cases per 1,000 patient-years), but overall heart deaths did not increase.

    Does the study support the specific claim? Yes · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Heart failure risk with rosiglitazone

    How was the study done?

    Analysis of heart failure events in an open-label RCT (RECORD)

    How many people, animals or samples were studied?

    4,447; Type 2 diabetes on metformin or SU, HbA1c 7.9%

    What was actually found?

    HF HR 2.10.

    How large was the observed effect?

    HR 2.10 (1.35-3.27)

    What do the results mean in everyday life?

    Avoid in heart failure.

    What are the study's limitations?

    Open-label; sponsored and analysed by the manufacturer (GSK); relatively few HF events (90).

    What does it say about Elawady's specific claim?

    Supports C-ODD-09.

    Do the results apply to Germany and Europe?

    European trial.

    What can explicitly not be concluded from this study?

    Increased overall CV mortality.

    Scientific details →

Studies contradicting or limiting the claim (0)

No studies in this group.

Studies with mixed or unclear results (1)

  • RECORD: rosiglitazone heart outcomes

    Home PD et al.. Lancet 2009 · PMID 19501900 · DOI 10.1016/S0140-6736(09)60953-3
    Randomised controlled trialindependent cross-checkabstract only checked★ key study

    Overall heart outcomes were not worse, but heart failure doubled; heart-attack effect unclear.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    CV outcomes of add-on rosiglitazone

    How was the study done?

    Multicentre open-label RCT (RECORD main results)

    How many people, animals or samples were studied?

    4,447; Type 2 diabetes on metformin or SU, HbA1c 7.9%

    What was actually found?

    Non-inferior CV; HF HR 2.10.

    How large was the observed effect?

    HR 0.99 primary

    What do the results mean in everyday life?

    Avoid in heart failure.

    What are the study's limitations?

    Open-label; Manufacturer funded; Low event rates

    What does it say about Elawady's specific claim?

    Supports HF part, limits MI part of C-ODD-09; limits C-ODD-05.

    Do the results apply to Germany and Europe?

    European trial.

    What can explicitly not be concluded from this study?

    Settle MI risk.

    Scientific details →

Regional context

Germany / EU

Not available in the EU since 2010 (to be verified).

Egypt

Availability in Egypt not verified.

What applies in my country?

General scientific assessment

Mostly true Heart-failure harm confirmed; heart-attack harm suggested but not settled.

This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.

References

  1. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes.. Nissen SE et al.. N Engl J Med 2007 · PMID 17517853 · DOI 10.1056/NEJMoa072761
  2. Heart failure events with rosiglitazone in type 2 diabetes: data from the RECORD clinical trial.. Komajda M et al.. Eur Heart J 2010 · PMID 20118174 · DOI 10.1093/eurheartj/ehp604
  3. Rosiglitazone evaluated for cardiovascular outcomes in oral agent combination therapy for type 2 diabetes (RECORD): a multicentre, randomised, open-label trial.. Home PD et al.. Lancet 2009 · PMID 19501900 · DOI 10.1016/S0140-6736(09)60953-3

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