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New use of rosiglitazone decreased following publication of a meta‐analysis suggesting harm
Author(s) -
Shah B. R.,
Juurlink D. N.,
Austin P. C.,
Mamdani M. M.
Publication year - 2008
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2008.02462.x
Subject(s) - rosiglitazone , pioglitazone , medicine , glibenclamide , metformin , meta analysis , medical prescription , harm , thiazolidinedione , drug , diabetes mellitus , type 2 diabetes , insulin , pharmacology , endocrinology , political science , law
Aims It is uncertain whether meta‐analyses lead to changes in prescribing practices. We studied trends in the prescribing of glucose‐lowering therapy before and after the publication of a meta‐analysis suggesting harm from rosiglitazone. Methods We examined the prescription records of all residents of Ontario, Canada, aged ≥ 66 years. For each week between January and December 2007, we identified new users of five categories of glucose‐lowering medications: rosiglitazone, pioglitazone, metformin, glibenclamide (glyburide) and insulin. The effect of the meta‐analysis was assessed using interventional autoregressive integrated moving‐average models. Results Following the release of the meta‐analysis, there was a sudden decline in new users of rosiglitazone ( P = 0.01), mirrored by a nearly identical but transient increase in new users of pioglitazone ( P < 0.001). There was also a net decline in new users of thiazolidinediones as a class ( P < 0.001). The number of new users of other glucose‐lowering medications did not change. Conclusions A highly‐publicized meta‐analysis regarding rosiglitazone's potential harms led to an abrupt decline in new users of the drug, as well as a transient surge in new use of pioglitazone.