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Troglitazone is a novel antidiabetic agent of the thiazolidinedione family that can be used to improve insulin resistance. Its pharmacological agonist actions are mediated by peroxisome proliferator–activated receptor- (PPAR-). Peroxisome proliferator–activated receptor- agonists, 15-deoxy-^12,14-prostaglandin J₂, and troglitazone have been shown to inhibit the secretion of inflammatory cytokines from monocytes, suggesting that there may be a therapeutic application of PPAR- agonists for chronic inflammatory diseases, such as rheumatoid arthritis.^1-2 We report a case in which the patient's rheumatoid arthritis deteriorated after administration of troglitazone (Noscal; Sankyo Co Ltd, Tokyo, Japan).

Report of a Case

A 49-year-old woman with rheumatoid arthritis for 30 years had been treated with ketoprofen (75 mg/d), oxaprozin (400 mg/d), and prednisolone (5 mg/d). She also received occasional steroid injections to her shoulder and knee joints. She was diagnosed as having diabetes at the age of 44 years, and treatment with glyburide (glibenclamide) was instituted. The dosage of glyburide . . . [Full Text of this Article]

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