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Prescribing pattern of glucose lowering drugs in the U nited K ingdom in the last decade: a focus on the effects of safety warnings about rosiglitazone
Author(s) -
Leal Ingrid,
Romio Silvana A.,
Schuemie Martijn,
Oteri Alessandro,
Sturkenboom Miriam,
Trifirò Gianluca
Publication year - 2013
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.2012.04401.x
Subject(s) - rosiglitazone , pioglitazone , medicine , medical prescription , incidence (geometry) , metformin , pharmacology , type 2 diabetes , endocrinology , diabetes mellitus , receptor , physics , optics
Aim In the last decade, new glucose lowering drugs ( GLDs ) have been launched, and also several warnings regarding their safety. The cardiovascular safety of thiazolidinediones ( TZD ) has been questioned. We analyzed the prescription pattern of GLDs from 2000 to N ovember 2009 in the U nited K ingdom ( UK ) using the THIN database with special focus on the effects of the safety warnings about rosiglitazone issued in M ay 2007 and J anuary 2008. Methods Annual prevalence and incidence of GLD prescriptions were measured. For TZD , the monthly prevalence and incidence of prescription were calculated from M ay 2006 to J anuary 2009. The switching pattern around the FDA alert and the characteristics of subjects starting treatment with TZD before and after the alerts were observed. Results The prevalence of prescriptions of GLDs increased during the 10 year period, metformin increasing more than three times. Rosiglitazone prevalence showed an increased trend until M ay 2007, (2.3/1000 person‐years) and decreased thereafter ( J anuary 2009: 1.1/1000 person‐years). The use of pioglitazone increased surpassing rosiglitazone from A pril 2008 onwards. The incidence of rosiglitazone use decreased sharply after M ay 2007 (0.8/1000 person‐years). The prevalence of use of other therapies remained rather stable from 2000 to 2007 but increased afterwards. After M ay 2007, rosiglitazone users were increasingly switched to pioglitazone. There was an increased proportion of new users of pioglitazone with cardiovascular risk after the alerts. Conclusions The prescription of GLDs in the UK has increased in the last decade. For TZDs , it changed after M ay 2007 as well as the characteristics of the subjects treated with them.