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Antidiabetic prescribing trends and predictors of thiazolidinedione discontinuation following the 2007 rosiglitazone safety alert
Diabetes Research and Clinical Practice, 08/15/2011
Clinical Article
Hurren KM et al. – The findings suggest that FDA advisories may be associated with substantial changes in medication use.
Methods- The authors performed a retrospective cohort analysis.
- Patients with two prescriptions for a TZD between 1 January and 21 May 2007, including one covering 21 May 2007, and continuous enrolment during 2006–2007 were identified from the MarketScan database.
- Multivariate logistic regression analysis was used to compare characteristics between patients who continued and discontinued each thiazolidinedione (TZD).
- They identified 40,836 and 37,183 individuals with a current prescription for rosiglitazone and pioglitazone, respectively.
- Significantly more rosiglitazone (53.5%) compared to pioglitazone users (21.4%) discontinued initial therapy six months after the alert (p<0.001).
- Approximately 23% of patients who discontinued rosiglitazone were switched to pioglitazone, while <1% was switched from pioglitazone to rosiglitazone
- Notably, 19.4% of patients who discontinued rosiglitazone and 36.1% of those who discontinued pioglitazone did not have evidence of any antidiabetic drug at follow-up.
- There was a significant decrease in metformin and an increase in sitagliptin prescribing in patients who discontinued TZDs.
- Age, sex, region, cardiovascular comorbidities and physician specialty predicted TZD discontinuation.
