Comments on: MTRAC reviews diabetes drugs http://www.prescriber.org.uk/2007/07/27/mtrac-reviews-diabetes-drugs/ An NHS Prescribing Advisers' Blog Fri, 29 Aug 2008 17:59:56 +0000 http://wordpress.org/?v=2.6.1 By: Matthew Robinson http://www.prescriber.org.uk/2007/07/27/mtrac-reviews-diabetes-drugs/#comment-1730 Matthew Robinson Sun, 29 Jul 2007 18:18:58 +0000 http://www.prescriber.org.uk/?p=402#comment-1730 Benedict, As you rightly point out, the currently available evidence overwhelmingly supports using Metformin first line. It is the only antidiabetic agent proven to prevent cardiovascular events and through doing so saves lives. In some circles here in England we call is <strong>Stormin' Metformin!</strong> Benedict,

As you rightly point out, the currently available evidence overwhelmingly supports using Metformin first line. It is the only antidiabetic agent proven to prevent cardiovascular events and through doing so saves lives.

In some circles here in England we call is Stormin’ Metformin!

]]> By: Benedict http://www.prescriber.org.uk/2007/07/27/mtrac-reviews-diabetes-drugs/#comment-1726 Benedict Sun, 29 Jul 2007 08:05:30 +0000 http://www.prescriber.org.uk/?p=402#comment-1726 With the unwelcome attention Rosiglitazone has been getting some attention has been paid to the other glitazone Pioglitazone, that (from memory) had a non-significant drop in blood inflammatory markers in trials comparing it placebo, whereas Rosiglitazone had a small but significant increase. So if the rates of acute cardiac events in Rosiglitazone are related to these inflammatory markers and pioglitazone therefore may have safer cardiac risk factors. Given Rosiglitazone makers GSK seem to be designing the recently published trials to encourage early (first line) or even prediabetic use of Rosiglitazone I would not be surprised to see Pioglitazone (?Takeda - In Oz Marketed by Lilly) makers pushing for it's product to be used early instead. So I feel this message probably really needs to be said widely and loudly before a $3 a tablet medication versus a $0.15 one gets promoted without clear evidence of any clear benefit over the older and cheaper medication. Benedict With the unwelcome attention Rosiglitazone has been getting some attention has been paid to the other glitazone Pioglitazone, that (from memory) had a non-significant drop in blood inflammatory markers in trials comparing it placebo, whereas Rosiglitazone had a small but significant increase. So if the rates of acute cardiac events in Rosiglitazone are related to these inflammatory markers and pioglitazone therefore may have safer cardiac risk factors.

Given Rosiglitazone makers GSK seem to be designing the recently published trials to encourage early (first line) or even prediabetic use of Rosiglitazone I would not be surprised to see Pioglitazone (?Takeda - In Oz Marketed by Lilly) makers pushing for it’s product to be used early instead.

So I feel this message probably really needs to be said widely and loudly before a $3 a tablet medication versus a $0.15 one gets promoted without clear evidence of any clear benefit over the older and cheaper medication.

Benedict

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