title: Residual effect of reductions in red blood cell count and haematocrit and haemoglobin levels after 10-month withdrawal of pioglitazone in patients with Type 2 diabetes.
abstract: OBJECTIVE
  To investigate the recovery of thiazolidinedione-induced body weight gain and haematopoietic changes after stopping pioglitazone treatment in patients with Type 2 diabetes.
  
  
  METHODS
  This retrospective cohort study included 214 patients divided into three groups according to pioglitazone treatment status. The first study arm included patients who received pioglitazone for 38 months then interrupted this for 10 months (pioglitazone-interruption group). The second arm consisted of patients who received pioglitazone throughout the 48 months (pioglitazone-continuous group); the third arm included patients who had never received pioglitazone therapy (control group).
  
  
  RESULTS
  Red blood cell count and haematocrit and haemoglobin levels decreased significantly, while body weight increased in the two pioglitazone-treated groups as compared with the control group at 38 months. Multivariate regression analysis showed that the reductions in red blood cell count/haemoglobin levels were associated with pioglitazone use. In the pioglitazone-interruption group, no recoveries of red blood cells, or haematocrit or haemoglobin levels were observed after stopping pioglitazone for 10 months compared with the pioglitazone-continuous group, but body weight gain decreased to a level that was significantly lower than that in the pioglitazone-continuous group and did not differ significantly from the control group.
  
  
  CONCLUSIONS
  In this study, we observed a reversal of body weight gain but no recoveries in red blood cells or haematocrit or haemoglobin levels after stopping pioglitazone for 10 months in patients treated with pioglitazone for 38 months. This finding should prompt a reconsideration of the sustained effect of thiazolidinediones on the haematopoietic system in patients with Type 2 diabetes.
authors.affiliation: The Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Columbia, SC, USA; Division of Endocrinology and Metabolism, Columbia, SC, USA.
authors.forename: K-D
authors.initials: KD
authors.lastname: Lin
authors.forename: M-Y
authors.initials: MY
authors.lastname: Lee
authors.forename: C-C
authors.initials: CC
authors.lastname: Feng
authors.forename: B K
authors.initials: BK
authors.lastname: Chen
authors.forename: M-L
authors.initials: ML
authors.lastname: Yu
authors.forename: S-J
authors.initials: SJ
authors.lastname: Shin
mesh_terms: D000368:Aged; D000740:Anemia / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D016903:Drug Monitoring; D004906:Erythrocyte Count; D005260:Female; D005500:Follow-Up Studies; D006400:Hematocrit; D006410:Hematopoiesis / Q000187:drug effects*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D000077205:Pioglitazone; D012189:Retrospective Studies; D012306:Risk; D013624:Taiwan / Q000453:epidemiology; D045162:Thiazolidinediones / Q000009:adverse effects* / Q000627:therapeutic use; D015430:Weight Gain / Q000187:drug effects
chemical_list: D006454:Hemoglobins; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077205:Pioglitazone