Troglitazone (TGZ, brand name: Rezulin and Prelay) is a peroxisome proliferator-activated receptor gamma (PPAR gamma) ligand, which was developed by Daiichi Sankyo and approved for the US market for the treatment of Type II diabetes mellitus. The drug is used alone or in combination with a sulfonylurea, metformin, or insulin as an adjunct to diet and exercise, and was not indicated as initial therapy in patients with type 2 diabetes. This drug was withdrawn from the UK market due to liver toxicity. It was removed from the US market in 2000, only 3 years after its introduction and from Japan, shortly afterward. In addition, was conducted a clinical trial for the treatment of patients with advanced liposarcoma by using troglitazone, but the positive result wasn’t obtained. It was shown, that in case of cancer cells troglitazone acted independently of PPAR gamma, by up-regulation of early growth response-1 (Egr-1). Egr-1 transcription factor has been linked to apoptosis and shown to be activated by extracellular signal-regulated kinase (ERK).
Originator
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
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Target ID: CHEMBL235 Sources: https://www.ncbi.nlm.nih.gov/pubmed/10691680 |
780.0 nM [EC50] | ||
Target ID: P18146 Gene ID: 1958.0 Gene Symbol: EGR1 Target Organism: Homo sapiens (Human) Sources: https://www.ncbi.nlm.nih.gov/pubmed/12475986 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
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Primary | Unknown Approved UseUnknown |
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Palliative | PRELAY Approved UsePrelay is indicated to improve glycemic control in patients with type 2 diabetes mellitus as an adjunct to diet and exercise in combination with (not substituted for): · A sulfonylurea drug for patients who are not adequately controlled with a sulfonylurea alone or, · A sulfonylurea drug together with metformin for patients who are not adequately controlled with the combination of a sulfonylurea and metformin or, · Insulin in patients who are not adequately controlled with insulin alone. Prelay is not indicated as initial therapy in patients with type 2 diabetes Launch Date1997 |
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Primary | Unknown Approved UseUnknown |
PubMed
Title | Date | PubMed |
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Troglitazone, a PPARgamma ligand, inhibits osteopontin gene expression in human monocytes/macrophage THP-1 cells. | 2000 |
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Dehydroepiandrosterone suppresses elevated hepatic glucose-6-phosphatase mRNA level in C57BL/KsJ-db/db mice: comparison with troglitazone. | 2000 Dec |
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Effects of type-2 diabetes and troglitazone on the expression patterns of small intestinal sugar transporters and PPAR-gamma in the Zucker diabetic fatty rat. | 2001 |
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Troglitazone, a ligand for peroxisome proliferator-activated receptor gamma, inhibits chemically-induced aberrant crypt foci in rats. | 2001 Apr |
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Effect of obesity and troglitazone on expression of two glutathione peroxidases: cellular and extracellular types in serum, kidney and adipose tissue. | 2001 Apr |
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Peroxisome proliferator-activated receptor gamma ligands suppress the transcriptional activation of cyclooxygenase-2. Evidence for involvement of activator protein-1 and CREB-binding protein/p300. | 2001 Apr 13 |
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Dual function of troglitazone in ICAM-1 gene expression in human vascular endothelium. | 2001 Apr 6 |
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Arylhydrocarbon receptor (AhR) is involved in negative regulation of adipose differentiation in 3T3-L1 cells: AhR inhibits adipose differentiation independently of dioxin. | 2001 Aug |
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15-Deoxy-delta 12,14-prostaglandin J2 and thiazolidinediones activate the MEK/ERK pathway through phosphatidylinositol 3-kinase in vascular smooth muscle cells. | 2001 Dec 28 |
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Myositis, microvesicular hepatitis, and progression to cirrhosis from troglitazone added to simvastatin. | 2001 Feb |
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Abundant expression of uncoupling protein-2 in the small intestine: up-regulation by dietary fish oil and fibrates. | 2001 Jan 15 |
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Nuclear factor-kappaB suppressive and inhibitor-kappaB stimulatory effects of troglitazone in obese patients with type 2 diabetes: evidence of an antiinflammatory action? | 2001 Jul |
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15-Deoxy-delta12,14-PGJ2, but not troglitazone, modulates IL-1beta effects in human chondrocytes by inhibiting NF-kappaB and AP-1 activation pathways. | 2001 Jul 13 |
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Troglitazone inhibits atherosclerosis in apolipoprotein E-knockout mice: pleiotropic effects on CD36 expression and HDL. | 2001 Mar |
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Bezafibrate attenuates the overexpression of plasminogen activator inhibitor-1 messenger RNA by a combination of mono-unsaturated fatty acid and insulin in hepG2 cells. | 2001 Mar 9 |
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Severe cholestatic hepatitis from troglitazone in a patient with nonalcoholic steatohepatitis and diabetes mellitus. | 2001 May |
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Involvement of p21(WAF1/Cip1), p27(Kip1), and p18(INK4c) in troglitazone-induced cell-cycle arrest in human hepatoma cell lines. | 2001 May |
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Troglitazone treatment increases plasma vascular endothelial growth factor in diabetic patients and its mRNA in 3T3-L1 adipocytes. | 2001 May |
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Troglitazone induces GLUT4 translocation in L6 myotubes. | 2001 May |
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Peroxisome proliferator-activated receptor-gamma agonist troglitazone protects against nondiabetic glomerulosclerosis in rats. | 2001 May |
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Troglitazone improves endothelial function and augments renal klotho mRNA expression in Otsuka Long-Evans Tokushima Fatty (OLETF) rats with multiple atherogenic risk factors. | 2001 Nov |
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Troglitazone selectively inhibits glyoxalase I gene expression. | 2001 Nov |
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Inhibition of phosphoenolpyruvate carboxykinase (PEPCK) gene expression by troglitazone: a peroxisome proliferator-activated receptor-gamma (PPARgamma)-independent, antioxidant-related mechanism. | 2001 Oct 15 |
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Troglitazone-induced intrahepatic cholestasis by an interference with the hepatobiliary export of bile acids in male and female rats. Correlation with the gender difference in troglitazone sulfate formation and the inhibition of the canalicular bile salt export pump (Bsep) by troglitazone and troglitazone sulfate. | 2001 Oct 5 |
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Regulation of the glyoxalase pathway in human brain microvascular endothelium: effects of troglitazone and tertiary butylhydroperoxide. | 2002 |
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Concentration-dependent stimulatory and inhibitory effect of troglitazone on insulin-induced fatty acid synthase expression and protein kinase B activity in 3T3-L1 adipocytes. | 2002 Apr |
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Troglitazone suppresses the secretion of type I collagen by mesangial cells in vitro. | 2002 Apr |
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Troglitazone downregulates delta-6 desaturase gene expression in human skeletal muscle cell cultures. | 2002 Apr |
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Thiazolidinedione derivatives ameliorate albuminuria in streptozotocin-induced diabetic spontaneous hypertensive rat. | 2002 Apr |
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Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) activation suppresses ischemic induction of Egr-1 and its inflammatory gene targets. | 2002 Dec |
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Receptor-dependent regulation of the CYP3A4 gene. | 2002 Dec 27 |
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Troglitazone suppresses cell growth of KU812 cells independently of PPARgamma. | 2002 Feb 1 |
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Unique ability of troglitazone to up-regulate peroxisome proliferator-activated receptor-gamma expression in hepatocytes. | 2002 Jan |
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Growth inhibition and differentiation of pancreatic cancer cell lines by PPAR gamma ligand troglitazone. | 2002 Jan |
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Fibrate and statin synergistically increase the transcriptional activities of PPARalpha/RXRalpha and decrease the transactivation of NFkappaB. | 2002 Jan 11 |
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Troglitazone inhibits both post-glutamate neurotoxicity and low-potassium-induced apoptosis in cerebellar granule neurons. | 2002 Jan 11 |
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Troglitazone induces G1 arrest by p27(Kip1) induction that is mediated by inhibition of proteasome in human gastric cancer cells. | 2002 Jul |
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Nonsteroidal anti-inflammatory drugs induce apoptosis in association with activation of peroxisome proliferator-activated receptor gamma in rheumatoid synovial cells. | 2002 Jul |
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Troglitazone improves GLUT4 expression in adipose tissue in an animal model of obese type 2 diabetes mellitus. | 2002 Jun |
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PPAR gamma ligands, troglitazone and pioglitazone, up-regulate expression of HMG-CoA synthase and HMG-CoA reductase gene in THP-1 macrophages. | 2002 Jun 5 |
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Troglitazone, an insulin-sensitizing thiazolidinedione, represses combined stimulation by LH and insulin of de novo androgen biosynthesis by thecal cells in vitro. | 2002 Mar |
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Effects of 1,1,1-trichloro-2,2-bis(p-chlorophenyl)-ethane (p,p'-DDT) on 3T3-L1 and 3T3-F442A adipocyte differentiation. | 2002 Mar 1 |
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Troglitazone treatment of aging Brown Norway rats improves food intake and weight gain after fasting without increasing hypothalamic NPY gene expression. | 2002 May |
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Troglitazone activates p21Cip/WAF1 through the ERK pathway in HCT15 human colorectal cancer cells. | 2002 May 28 |
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Effects of leptin, troglitazone, and dietary fat on stearoyl CoA desaturase. | 2002 Oct 11 |
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Comparative effects of thiazolidinediones on in vitro P450 enzyme induction and inhibition. | 2003 Apr |
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The effects of troglitazone, an insulin-sensitizing agent, on the endothelial function in early and late type 2 diabetes: a placebo-controlled randomized clinical trial. | 2003 Feb |
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Troglitazone, a peroxisome proliferator-activated receptor gamma (PPAR gamma ) ligand, selectively induces the early growth response-1 gene independently of PPAR gamma. A novel mechanism for its anti-tumorigenic activity. | 2003 Feb 21 |
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Troglitazone but not rosiglitazone induces G1 cell cycle arrest and apoptosis in human and rat hepatoma cell lines. | 2003 Mar 20 |
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A cohort study of the incidence of serious acute liver injury in diabetic patients treated with hypoglycemic agents. | 2003 Mar 24 |
Sample Use Guides
Prelay (TROGLITAZONE tablet) should be taken with a meal.
Combination Therapy:
Sulfonylureas: Prelay in combination with a sulfonylurea should be initiated at 200 mg once daily. The current sulfonylurea dose should be continued upon initiation of Prelay therapy. For patients not responding adequately, the Rezulin dose should be increased at 2 to 4 weeks. The maximum recommended dose is 600 mg once daily. The dose of sulfonylurea may require lowering to optimize therapy.
Metformin: For patients not responding adequately to metformin and sulfonylurea therapy, 400 mg daily of Prelay may be added.
Insulin: The current insulin dose should be continued upon initiation of Prelay therapy. Prelay therapy should be initiated at 200 mg once daily in patients on insulin therapy. For patients not responding adequately, the dose of Prelay should be increased after approximately 2 to 4 weeks. The usual dose of Prelay is 400 mg once daily. The maximum recommended daily dose is 600 mg. It is recommended that the insulin dose be decreased by 10% to 25% when fasting plasma glucose concentrations decrease to less than 120 mg/dL in patients receiving concomitant insulin and Prelay. Further adjustments should be individualized based on glucose-lowering response.
Patients With Renal Insufficiency: Dose adjustment in patients with renal insufficiency is not required
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/16374840
Human HCC cell lines Huh7 and Hep3B were cultured in the presence or absence of troglitazone. Cell growth was determined via WST-1 assay, proliferation by cell cycle analysis and proliferating cell nuclear antigen (PCNA) Western blotting, and apoptosis by flow cytometry and TUNEL. In cultures of Hep3B and Huh7 cells, basal expression of PPARgamma was relatively low, but troglitazone caused dose-dependent induction of PPARgamma expression.
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Mixture
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on
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Record UNII |
I66ZZ0ZN0E
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C1934
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WHO-ATC |
A10BG01
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LIVERTOX |
NBK548142
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QA10BG01
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C98241
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Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
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Biological Half-life | PHARMACOKINETIC |
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