| アブストラクト | AIMS: To describe the withdrawal of rosiglitazone and the impact upon glycaemic control; intensification of therapy; and progression to major adverse cardiovascular events (MACE), cancer and mortality. METHODS: Data were from the Clinical Practice Research Datalink (CPRD), a longitudinal U.K. database. Rosiglitazone use was profiled from launch (2000) until withdrawal (2010). Patients discontinuing from July 2010 were included in the analysis to ascertain the impact on glycaemic control; therapy intensification; and progression to MACE, death and cancer. For comparison, patients were matched to those maintained on pioglitazone as a control group. RESULTS: Rosiglitazone use peaked in May 2007. Of patients prescribed rosiglitazone at discontinuation 54.1% patients used a dual-therapy regimen; most commonly with metformin (46.7%). 65.1% patients remained at the same stage of the diabetes pathway following discontinuation. 51.7% of patients replaced rosiglitazone with pioglitazone. Patients discontinuing were more likely (HR=2.29), to subsequently intensify therapy than controls. After discontinuation of rosiglitazone there was a significant increase in HbA1c, from a median of 6.9% to 7.3%. In matched analysis, there was a significantly greater increase in HbA1c for rosiglitazone patients (0.33% versus 0.10%). Following discontinuation, crude rates for MACE, cancer and mortality were 8.4, 17.9 and 15.8 pkpy, respectively. None was significantly different in the matched analysis. CONCLUSION: Withdrawal of rosiglitazone was associated with worsening glucose control and subsequent intensification of treatment regimen. |
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| ジャーナル名 | Journal of diabetes and its complications |
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| Pubmed追加日 | 2014/2/18 |
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| 投稿者 | Morgan, Christopher Ll; Puelles, Jorge; Poole, Chris D; Currie, Craig J |
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| 組織名 | Public Health and Primary Care, School of Medicine, Cardiff University, Cardiff;UK.;Health Economics and Outcomes Research, Takeda Europe, London, UK.;UK. Electronic address: currie@cardiff.ac.uk. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/24529918/ |
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