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No Impact of Pre‐existing Cardiovascular Disease on Prescribing Patterns of Sulphonylureas in Denmark – A Registry‐based Nationwide Study
Author(s) -
Nilsson Malin,
Rungby Jørgen,
Lassota Nathan,
Jørgensen Andreas D.,
Ibsen Rikke,
Kjellberg Jakob
Publication year - 2018
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.12961
Subject(s) - medicine , gliclazide , medical prescription , myocardial infarction , disease , diabetes mellitus , coronary heart disease , pharmacology , endocrinology
Uncertainty exists regarding cardiovascular ( CV ) safety of sulphonylureas ( SU s) as reflected in package labels and treatment guidelines. This study evaluated clinical treatment practice for SU s by analysing prescription patterns for SU s relative to patient history of CV disease ( CVD ). Patients in Denmark initiating treatment with SU or other anti‐hyperglycaemic drugs during 2006–12 were retrospectively identified using national health registries. Pre‐existing (previous 12 years) overall CVD , coronary heart disease ( CHD ) and myocardial infarction ( MI ) were subsequently identified. Proportion of patients with pre‐existing CVD was compared between new users of SU and new users of other anti‐hyperglycaemic drugs. In total, 50,425 (42.2% females, mean ± SD age 63.3 ± 13.5 years) and 190,438 (46.5% females, age 60.3 ± 15.0 years) patients initiated treatment with SU or other anti‐hyperglycaemic drugs, respectively, during 2006–12. The number of patients initiating SU treatment decreased by 63% during 2006–12. The proportion of patients with pre‐existing CVD varied between 46.9% and 49.8% among new SU users versus 39.9% and 44.8% among new users of other anti‐hyperglycaemic drugs. Corresponding proportions for CHD (17.9–19.9% versus 15.4–16.9%) and MI (6.3–7.5% versus 5.8–6.2%) showed the same pattern. Excluding new gliclazide users (9.6% of all new SU users) from the SU definition did not alter the results. Despite a potentially increased CV risk associated with use of SU s, pre‐existing CVD did not decrease clinicians’ relative prescriptions of SU s.