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Urology
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Pioglitazone use and Parkinson’s disease: a retrospective cohort study in Taiwan
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  • Published on: 7 September 2018
    Thiazolidinedione therapy and the risk of Parkinson Disease
    • Shih-Wei Lai, Attending physician China Medical University Hospital in Taiwan

    The effect of Thiazolidinedione therapy on the risk of Parkinson’s disease is controversial. One article by Wu and colleagues in Taiwan reported that pioglitazone use was not associated with the risk of Parkinson’s disease in people with diabetes mellitus (hazard ratio 0.90, 95% CI 0.68-1.18).1 To the contrary, another article by Lin and colleagues in Taiwan reported that thiazolidinedione use was associated with a 60% reduced risk of Parkinson’s disease in people with diabetes mellitus.2 Similarly, conflicting results were also found in Western countries.3,4 There was no measure of the hemoglobin A1c in the above studies. We cannot determine whether the risk of Parkinson’s disease is associated with good glycemic control or poor control among people on thiazolidinedione therapy. Therefore, any study exploring the association between anti-diabetic medications and Parkinson’s disease should estimate the hemoglobin A1c levels.
    Theoretically, a study should be designed to compare people on thiazolidinedione therapy only with those people not taking any medication. However, according to the recommendation of the American Diabetes Association, metformin is the first-line therapy for type 2 diabetes mellitus.5 People with diabetes mellitus usually take metformin alone or use combined therapy with other anti-diabetic medications. Thiazolidinedione is usually recommended as combined therapy with metformin for type 2 diabetes mellitus. So it is difficult to identify peo...

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    Conflict of Interest:
    None declared.