Study Finds Discontinuation Of Rosiglitazone Left Many Diabetes Patients Without Good Glycemic Control

Main Category: Diabetes
Also Included In: Clinical Trials / Drug Trials
Article Date: 15 Apr 2009 - 2:00 PDT

email to a friend   printer friendly   opinions  

When concerns were raised about the safety of the diabetes medication, rosiglitazone, in May 2007, many patients and their doctors made the decision to discontinue use of the drug. A study published in Endocrine Practice by Dr. Etta Fanning from the University of Texas Health Science Center along with her colleagues reported that many patients who discontinued use of rosiglitazone received less therapy and higher blood glucose levels as a result.

A meta-analysis published in 2007 showed an increased risk of cardiovascular disease and myocardial infarction for patients using rosiglitazone. After that data was published, the FDA placed a black box warning on both thiazolidinediones (TZD) on the market, rosiglitazone and pioglitazone.

The study published in Endocrine Practice entitled Clinical Practice Impact of Rosiglitazone Discontinuation on Glycemic Control shows that 89% of patients in the study group were using combination therapy before discontinuing use of rosiglitazone. After discontinuation, only 33% of patients were on a combination therapy. Another 13% of the group were not prescribed any diabetes medication at all.

The glycemic control of the group was also impacted after discontinuing rosiglitazone. In patients who received combination therapy, and who had laboratory values in both pre- and post-discontinuation periods, significant increases were observed in both fasting blood glucose and A1c.

In an accompanying Editorial, cardiologists Drs. Stuart Zarich and Dr. Richard Nesto, from Yale Medical School and Lahey Clinic, respectively, emphasized that patients who discontinue TZD's are at risk for higher fasting blood glucose and hemoglobin A1c levels, as reported by Fanning et al, which might further their cardiovascular risk. Furthermore, they point out that 5 large prospective studies have not found that rosiglitazone has any more cardiovascular risk than placebo or other hypoglycemic drugs and that a recent meta-analysis has also shown that TZD's do not increase cardiovascular mortality.

About Endocrine Practice

Endocrine Practice, a peer-reviewed journal published seven times a year, is the official journal of the American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.

About the American Association of Clinical Endocrinologists (AACE)

AACE is a professional medical organization with more than 6,200 members in the United States and 92 other countries. Founded in 1991, AACE is dedicated to the optimal care of patients with endocrine problems. AACE clinical endocrinologists advanced, specialized training enable them to be experts in the care of endocrine disease such as diabetes, thyroid disorders, growth hormone deficiency, osteoporosis, cholesterol disorders, hypertension and obesity.

Source: American Association of Clinical Endocrinologists

• Additional
• References
• Citations