Pioglitazone Linked to Lower Risks in Older Diabetics

Head-to-head comparison shows reduced risk of heart failure and death compared to rosiglitazone

WEDNESDAY, Aug. 19 (HealthDay News) -- In elderly diabetics, pioglitazone may be associated with a significantly lower risk of heart failure and death than rosiglitazone, according to a study published online Aug. 18 in BMJ.

David N. Juurlink, M.D., of the Sunnybrook Health Sciences Centre in Toronto, and colleagues used an insurance claims database to study 39,736 patients ages 66 years and older who began taking rosiglitazone or pioglitazone between April 2002 and March 2008.

Compared to rosiglitazone, the researchers found that pioglitazone was associated with a reduced risk of heart failure and overall mortality (adjusted hazard ratios, 0.77 and 0.86, respectively) but not myocardial infarction (adjusted hazard ratio, 0.95).

"Given the accumulating evidence of harm with rosiglitazone treatment and the lack of a distinct clinical advantage for the drug over pioglitazone, questioning whether ongoing use of rosiglitazone is justified in any circumstance is reasonable," the authors conclude. "Pending the availability of additional data on the benefits and harms of these drugs and a clarification of their role in the pharmacotherapy of type 2 diabetes, we believe that clinicians should re-evaluate the appropriateness of new or ongoing treatment with rosiglitazone."

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