Impact of thiazolidinedione safety warnings on medication use patterns and glycemic control among veterans with diabetes mellitus

Abstract Aims In 2007, safety warnings were publicized regarding the association between thiazolidinediones (TZDs) and cardiovascular risks. This study investigated the impact of the publicized safety warnings on glycemic outcomes in patients with diabetes mellitus (DM). Materials and Methods The Veterans Integrated Services Network 16 database included 13,293 DM patients using TZDs ( n =13,037 rosiglitazone, n =246 pioglitazone, n =10 both) during a baseline period of 03/01/07 to 05/31/07. Three medication use patterns groups (09/01/07 to 11/30/07) were defined as follows: (1) continuation on TZD treatment, (2) switching to other non-TZD treatment, (3) discontinuation of TZD treatment without any antidiabetic treatment. Primary outcome (09/01/07 to 02/29/08) was change from baseline in A1c. The analysis of variance was used to test the association between use patterns and A1c change. A logistic regression model was used to identify the predictors for use patterns. Results Patients (45.1%, n =5999) discontinued their TZD use. Both Groups 2 and 3 had significant A1c increases (both P values P P P Conclusion Thiazolidinedione safety warnings may have negatively impacted the glycemic control in DM patients.