The Midlands Therapeutics Review and Advisory Committee (MTRAC) has issued updated advice for pioglitazone (Actos®) and rosiglitazone (Avandia®).
The pioglitazone review places this drug as having weaker evidence and having a lower place in therapy. It is suitable for restricted prescribing in primary care because of conflicting evidence in the long-term clinical effects of this drug on cardiovascular outcomes.
The rosiglitazone review recommends that this drug should not be prescribed in primary care because of "inadequate evidence of safety and/or efficacy".
Action: Current recommendations still stand. Metformin continues to be the first choice oral hypoglycaemic with a sulphonylurea added in as second line. This is based upon a proven record of efficacy and safety.
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