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Variation in Association Between Thiazolidinediones and Heart Failure Across Ethnic Groups: Retrospective analysis of Large Healthcare Claims Databases in Six Countries.

Roughead EE, Chan EW, Choi NK, Kimura M, Kimura T, Kubota K, Lai EC, Man KK, Nguyen TA, Ooba N, Park BJ, Sato T, Shin JY, Wang T, Griffiths J, Wong IC, Yang YH, Pratt NL - Drug Saf (2015)

Bottom Line: Pooled estimates of risk for furosemide initiation in the Caucasian populations were significantly increased for pioglitazone [adjusted sequence ratio (ASR) 1.47; 95 % confidence interval (CI) 1.14-1.91] and rosiglitazone (ASR 1.65; 95 % CI 1.58-1.72), while in the Asian populations, the pooled risk estimates were lower (ASR 1.11; 95 % CI 0.93-1.32 and ASR 1.21; 95 % CI 1.01-1.45 for pioglitazone and rosiglitazone, respectively).Results for hospitalisation for heart failure showed a similar trend, with elevated risk in the Australian data (ASR 1.88; 95 % CI 1.01-3.5 and ASR 1.25; 95 % CI 0.76-2.05 for pioglitazone and rosiglitazone, respectively), while no increased risk was found in the pooled results for the Asian populations.Assessment of adverse events by ethnicity may support safer medicine use.

View Article: PubMed Central - PubMed

Affiliation: Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.

ABSTRACT

Introduction: The prevalence of polymorphisms among the metabolising enzymes and pharmacodynamic receptors relevant for the thiazolidinediones differs by ethnic group, a factor that may modify risk of adverse drug events.

Objective: The aim of the study was to determine if the risk of oedema or heart failure associated with the thiazolidinediones varies in populations in Australia, Canada, Hong Kong, Japan, Korea and Taiwan.

Methods: Sequence symmetry analyses were undertaken to investigate the risk of peripheral oedema, as measured by incident furosemide dispensing, and risk of hospitalisations for heart failure. Results were pooled, with Australia and Canada representing predominantly Caucasian population and all other countries contributing to Asian population estimates.

Results: Pooled estimates of risk for furosemide initiation in the Caucasian populations were significantly increased for pioglitazone [adjusted sequence ratio (ASR) 1.47; 95 % confidence interval (CI) 1.14-1.91] and rosiglitazone (ASR 1.65; 95 % CI 1.58-1.72), while in the Asian populations, the pooled risk estimates were lower (ASR 1.11; 95 % CI 0.93-1.32 and ASR 1.21; 95 % CI 1.01-1.45 for pioglitazone and rosiglitazone, respectively). Results for hospitalisation for heart failure showed a similar trend, with elevated risk in the Australian data (ASR 1.88; 95 % CI 1.01-3.5 and ASR 1.25; 95 % CI 0.76-2.05 for pioglitazone and rosiglitazone, respectively), while no increased risk was found in the pooled results for the Asian populations.

Conclusion: The risk of both oedema and heart failure with thiazolidinediones was higher in predominantly Caucasian countries than in the Asian countries assessed. Assessment of adverse events by ethnicity may support safer medicine use.

No MeSH data available.


Related in: MedlinePlus

Sequence symmetry analysis results for incident rosiglitazone use and risk of incident furosemide use. Aust (DVA) Australian Government Department of Veterans’ Affairs healthcare claims database, Australia Australian Government Drug Utilisation Subcommittee dataset, CI confidence interval, IV inverse variance, SE standard error
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Fig1: Sequence symmetry analysis results for incident rosiglitazone use and risk of incident furosemide use. Aust (DVA) Australian Government Department of Veterans’ Affairs healthcare claims database, Australia Australian Government Drug Utilisation Subcommittee dataset, CI confidence interval, IV inverse variance, SE standard error

Mentions: With regards to the oedema outcome, there were significant associations between incident rosiglitazone use and incident furosemide dispensing in Australia and Canada, with the pooled Australia–Canada estimate also significant [adjusted sequence ratio (ASR) 1.65; 95 % CI 1.58–1.72] (Fig. 1). Korea and Taiwan had similar point estimates, with only the result in Korea reaching statistical significance. These risk estimates were lower than Australia–Canada results (Fig. 1). There was a significant elevated risk in Hong Kong, which was of greater magnitude than the risk identified in the predominantly Caucasian populations. The pooled estimate for the Asian population was significant (ASR 1.21; 95 % CI 1.01–1.45), but the magnitude of the estimate was lower than the predominantly Caucasian population result.Fig. 1


Variation in Association Between Thiazolidinediones and Heart Failure Across Ethnic Groups: Retrospective analysis of Large Healthcare Claims Databases in Six Countries.

Roughead EE, Chan EW, Choi NK, Kimura M, Kimura T, Kubota K, Lai EC, Man KK, Nguyen TA, Ooba N, Park BJ, Sato T, Shin JY, Wang T, Griffiths J, Wong IC, Yang YH, Pratt NL - Drug Saf (2015)

Sequence symmetry analysis results for incident rosiglitazone use and risk of incident furosemide use. Aust (DVA) Australian Government Department of Veterans’ Affairs healthcare claims database, Australia Australian Government Drug Utilisation Subcommittee dataset, CI confidence interval, IV inverse variance, SE standard error
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4561996&req=5

Fig1: Sequence symmetry analysis results for incident rosiglitazone use and risk of incident furosemide use. Aust (DVA) Australian Government Department of Veterans’ Affairs healthcare claims database, Australia Australian Government Drug Utilisation Subcommittee dataset, CI confidence interval, IV inverse variance, SE standard error
Mentions: With regards to the oedema outcome, there were significant associations between incident rosiglitazone use and incident furosemide dispensing in Australia and Canada, with the pooled Australia–Canada estimate also significant [adjusted sequence ratio (ASR) 1.65; 95 % CI 1.58–1.72] (Fig. 1). Korea and Taiwan had similar point estimates, with only the result in Korea reaching statistical significance. These risk estimates were lower than Australia–Canada results (Fig. 1). There was a significant elevated risk in Hong Kong, which was of greater magnitude than the risk identified in the predominantly Caucasian populations. The pooled estimate for the Asian population was significant (ASR 1.21; 95 % CI 1.01–1.45), but the magnitude of the estimate was lower than the predominantly Caucasian population result.Fig. 1

Bottom Line: Pooled estimates of risk for furosemide initiation in the Caucasian populations were significantly increased for pioglitazone [adjusted sequence ratio (ASR) 1.47; 95 % confidence interval (CI) 1.14-1.91] and rosiglitazone (ASR 1.65; 95 % CI 1.58-1.72), while in the Asian populations, the pooled risk estimates were lower (ASR 1.11; 95 % CI 0.93-1.32 and ASR 1.21; 95 % CI 1.01-1.45 for pioglitazone and rosiglitazone, respectively).Results for hospitalisation for heart failure showed a similar trend, with elevated risk in the Australian data (ASR 1.88; 95 % CI 1.01-3.5 and ASR 1.25; 95 % CI 0.76-2.05 for pioglitazone and rosiglitazone, respectively), while no increased risk was found in the pooled results for the Asian populations.Assessment of adverse events by ethnicity may support safer medicine use.

View Article: PubMed Central - PubMed

Affiliation: Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.

ABSTRACT

Introduction: The prevalence of polymorphisms among the metabolising enzymes and pharmacodynamic receptors relevant for the thiazolidinediones differs by ethnic group, a factor that may modify risk of adverse drug events.

Objective: The aim of the study was to determine if the risk of oedema or heart failure associated with the thiazolidinediones varies in populations in Australia, Canada, Hong Kong, Japan, Korea and Taiwan.

Methods: Sequence symmetry analyses were undertaken to investigate the risk of peripheral oedema, as measured by incident furosemide dispensing, and risk of hospitalisations for heart failure. Results were pooled, with Australia and Canada representing predominantly Caucasian population and all other countries contributing to Asian population estimates.

Results: Pooled estimates of risk for furosemide initiation in the Caucasian populations were significantly increased for pioglitazone [adjusted sequence ratio (ASR) 1.47; 95 % confidence interval (CI) 1.14-1.91] and rosiglitazone (ASR 1.65; 95 % CI 1.58-1.72), while in the Asian populations, the pooled risk estimates were lower (ASR 1.11; 95 % CI 0.93-1.32 and ASR 1.21; 95 % CI 1.01-1.45 for pioglitazone and rosiglitazone, respectively). Results for hospitalisation for heart failure showed a similar trend, with elevated risk in the Australian data (ASR 1.88; 95 % CI 1.01-3.5 and ASR 1.25; 95 % CI 0.76-2.05 for pioglitazone and rosiglitazone, respectively), while no increased risk was found in the pooled results for the Asian populations.

Conclusion: The risk of both oedema and heart failure with thiazolidinediones was higher in predominantly Caucasian countries than in the Asian countries assessed. Assessment of adverse events by ethnicity may support safer medicine use.

No MeSH data available.


Related in: MedlinePlus