Abstract
In this Practice Point commentary, we discuss the findings and limitations of a randomized, placebo-controlled trial conducted by Lewis and colleagues that examined the efficacy of rosiglitazone for the treatment of patients with mild-to-moderately active ulcerative colitis. The results show that rosiglitazone had superior efficacy to placebo for inducing clinical response and remission. However, the efficacy of rosiglitazone in this setting was modest. We believe that this finding might be attributable to the high numbers of patients included in the trial who were refractory to conventional therapy. Rosiglitazone might be more effective if combined with 5-aminosalicylic acid therapy and used in patients with less-refractory disease. We highlight the issues to consider when interpreting and generalizing these findings to clinical practice.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Nolte RT et al. (1998) Ligand binding and co-activator assembly of the peroxisome proliferator-activated receptor-gamma. Nature 395: 137–143
Marion R et al. (2008) Comparison of cytokine modulation by natural PPARγ ligands with synthetic ligands in intestinal-like Caco-2 cells—potential for dietary modulation of PPARγ in intestinal inflammation. Am J Clin Nutr 87: 939–948
Sanchez-Hidalgo M et al. (2005) Rosiglitazone, an agonist of peroxisome proliferator-activated receptor gamma, reduces chronic colonic inflammation in rats. Biochem Pharmacol 69: 1733–1744
Sanchez-Hildalgo M et al. (2007) Rosiglitazone. A PPARγ ligand, modulates signal transduction pathways during the development of acute TNBS-induced colitis in rats. Euro J Pharmacol 562: 247–258
Nencioni A et al. (2002) Dendritic cell immunogenicity is regulated by peroxisome proliferator-activated receptor gamma. J Immunol 169: 1228–1235
Narayanan BA et al. (2003) Modulation of inducible nitric oxide synthase and related proinflammatory genes by the omega-3 fatty acid docosahexaenoic acid in human colon cancer cells. Cancer Res 63: 972–979
Dubuquoy L et al. (2003) Impaired expression of peroxisome proliferator-activated receptor gamma in ulcerative colitis. Gastroenterology 124: 1265–1276
Rousseaux C et al. (2005) Intestinal antiinflammatory effect of 5-aminosalicylic acid is dependent on peroxisome proliferator-activated receptor-γ. J Exp Med 201: 1205–1215
Lewis JD et al. (2001) An open-label trial of the PPARγ ligand rosiglitazone for active ulcerative colitis. Am J Gastroenterol 96: 3323–3328
Lewis JD et al. (2008) Rosiglitazone for active ulcerative colitis: a randomised placebo-controlled trial. Gastroenterology 134: 688–695
Liang HL and Ouyang Q (2008) A clinical trial of combined use of rosiglitazone and 5-aminosalicylate for ulcerative colitis. World J Gastroenterol 14: 114–119
Singh S et al. (2007) Long-term risk of cardiovascular events with rosiglitazone: a meta-analysis. JAMA 298: 1189–1195
Acknowledgements
The authors acknowledge the contribution of Rachel Marion-Letellier, Appareil Digestif Environnement Nutrition, Institut Fédératif de Recherches Multidisciplinaires sur les Peptides (I.F.R.23), Roven, France, for her advice in drafting this manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Milestone, A., Iacucci, M. & Ghosh, S. Is rosiglitazone a promising treatment for ulcerative colitis?. Nat Rev Gastroenterol Hepatol 5, 486–487 (2008). https://doi.org/10.1038/ncpgasthep1226
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ncpgasthep1226