Clinical and demographic characteristics of patients receiving different oral hypoglycemic agents.
OBJECTIVE
To characterize the demographic and clinical profiles of older persons with diabetes treated with a thiazolidinedione (TZD) in comparison to other groups of patients, including all patients with diabetes and those taking other oral hypoglycemic agents (OHAs).


METHODS
We studied Ontario residents aged 66 and older and alive on 31 March 2008. Five groups were created based on diabetes status and history of treatment with OHAs, including patients prescribed rosiglitazone, patients prescribed pioglitazone, and a sample of three other groups: patients prescribed any other OHA in the preceding year, all patients with diabetes, and elderly Ontarians regardless of diabetes status. We excluded patients receiving insulin or multiple TZDs from the three OHA groups. Study groups were compared based on demographic information, measures of comorbidity, history of cardiovascular diseases, and concomitant use of drugs for cardiovascular disease.


RESULTS
People treated with pioglitazone (n = 16 206) were highly similar to those treated with rosiglitazone (n = 16 066). Individuals treated with either TZD tended to be younger, less likely to reside in a long-term care facility, and had similar cardiovascular profiles to samples of patients with diabetes (n = 50 000) and those taking other OHAs (n = 50 000).


CONCLUSIONS
Older patients started on TZDs have cardiovascular risk profiles comparable to other individuals with diabetes, including those taking other OHAs, suggesting that observational studies of TZD safety are not likely confounded by selection bias.
Gomes
Tara
T
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. tara.gomes@ices.on.ca
Juurlink
David N
DN
Lipscombe
Lorraine L
LL
Mamdani
Muhammad M
MM
D000284:Administration, Oral; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000139:chemically induced; D015897:Comorbidity; D003257:Consumer Product Safety; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D009864:Ontario / Q000453:epidemiology; D000077205:Pioglitazone; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000008:administration & dosage* / Q000009:adverse effects
D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D000077205:Pioglitazone