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Thiazolidinediones, cardiovascular disease and cardiovascular mortality: translating research into action for diabetes (TRIAD)
Author(s) -
Bilik Dori,
McEwen Laura N.,
Brown Morton B.,
Selby Joe V.,
Karter Andrew J.,
Marrero David G.,
Hsiao Victoria C.,
Tseng ChienWen,
Mangione Carol M.,
Lasser Norman L.,
Crosson Jesse C.,
Herman William H.
Publication year - 2010
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.1954
Subject(s) - pioglitazone , rosiglitazone , medicine , thiazolidinedione , hazard ratio , diabetes mellitus , observational study , proportional hazards model , type 2 diabetes , endocrinology , confidence interval
Background Studies have associated thiazolidinedione (TZD) treatment with cardiovascular disease (CVD) and questioned whether the two available TZDs, rosiglitazone and pioglitazone, have different CVD risks. We compared CVD incidence, cardiovascular (CV), and all‐cause mortality in type 2 diabetic patients treated with rosiglitazone or pioglitazone as their only TZD. Methods We analyzed survey, medical record, administrative, and National Death Index (NDI) data from 1999 through 2003 from Translating Research Into Action for Diabetes (TRIAD), a prospective observational study of diabetes care in managed care. Medications, CV procedures, and CVD were determined from health plan (HP) administrative data, and mortality was from NDI. Adjusted hazard rates (AHR) were derived from Cox proportional hazard models adjusted for age, sex, race/ethnicity, income, history of diabetic nephropathy, history of CVD, insulin use, and HP. Results Across TRIAD's 10 HPs, 1,815 patients (24%) filled prescriptions for a TZD, 773 (10%) for only rosiglitazone, 711 (10%) for only pioglitazone, and 331 (4%) for multiple TZDs. In the seven HPs using both TZDs, 1,159 patients (33%) filled a prescription for a TZD, 564 (16%) for only rosiglitazone, 334 (10%) for only pioglitazone, and 261 (7%) for multiple TZDs. For all CV events, CV, and all‐cause mortality, we found no significant difference between rosiglitazone and pioglitazone. Conclusions In this relatively small, prospective, observational study, we found no statistically significant differences in CV outcomes for rosiglitazone‐ compared to pioglitazone‐treated patients. There does not appear to be a pattern of clinically meaningful differences in CV outcomes for rosiglitazone‐ versus pioglitazone‐treated patients. Copyright © 2010 John Wiley & Sons, Ltd.