Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands.
Br J Clin Pharmacol. 2013 Mar;75(3):861-8. doi: 10.1111/j.1365-2125.2012.04401.x.
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 November 2009 in the United Kingdom (UK) using the THIN database with special focus on the effects of the safety warnings about rosiglitazone issued in May 2007 and January 2008.
Annual prevalence and incidence of GLD prescriptions were measured. For TZD, the monthly prevalence and incidence of prescription were calculated from May 2006 to January 2009. The switching pattern around the FDA alert and the characteristics of subjects starting treatment with TZD before and after the alerts were observed.
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 May 2007, (2.3/1000 person-years) and decreased thereafter (January 2009: 1.1/1000 person-years). The use of pioglitazone increased surpassing rosiglitazone from April 2008 onwards. The incidence of rosiglitazone use decreased sharply after May 2007 (0.8/1000 person-years). The prevalence of use of other therapies remained rather stable from 2000 to 2007 but increased afterwards. After May 2007, rosiglitazone users were increasingly switched to pioglitazone. There was an increased proportion of new users of pioglitazone with cardiovascular risk after the alerts.
The prescription of GLDs in the UK has increased in the last decade. For TZDs, it changed after May 2007 as well as the characteristics of the subjects treated with them.
在过去十年中，新的降糖药物（GLD）已被推出，同时也有一些关于其安全性的警告。噻唑烷二酮类药物（TZD）的心血管安全性受到质疑。我们使用 THIN 数据库分析了 2000 年至 2009 年 11 月英国（UK）GLD 的处方模式，特别关注 2007 年 5 月和 2008 年 1 月发布的关于罗格列酮安全性警告的影响。
测量 GLD 处方的年度流行率和发病率。对于 TZD，从 2006 年 5 月至 2009 年 1 月计算每月处方的流行率和发病率。观察 FDA 警告前后 TZD 开始治疗的转换模式和患者特征。
在 10 年期间，GLD 处方的流行率增加，二甲双胍增加了三倍多。罗格列酮的流行趋势呈上升趋势，直到 2007 年 5 月（2.3/1000人年），此后下降（2009 年 1 月：1.1/1000 人年）。自 2008 年 4 月以来，吡格列酮的使用量超过了罗格列酮。罗格列酮的使用率在 2007 年 5 月后急剧下降（0.8/1000 人年）。2000 年至 2007 年期间，其他疗法的使用率相对稳定，但此后增加。2007 年 5 月后，罗格列酮使用者越来越多地转为吡格列酮。在警告后，新使用具有心血管风险的吡格列酮的患者比例增加。
在过去十年中，英国 GLD 的处方量有所增加。对于 TZD，自 2007 年 5 月以来，其处方模式发生了变化，同时接受治疗的患者特征也发生了变化。
