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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 diabetes medicine use and risk of incident heart failure hospitalisation: Asian countries. CI confidence interval, Japan I Japan Medical Data Centre insurance claims database, IV inverse variance, SE standard error
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Fig4: Sequence symmetry analysis results for incident diabetes medicine use and risk of incident heart failure hospitalisation: Asian countries. CI confidence interval, Japan I Japan Medical Data Centre insurance claims database, IV inverse variance, SE standard error

Mentions: No significant risk was observed for rosiglitazone use and heart failure hospitalisation in Taiwan; however, a significantly elevated risk was observed in Hong Kong (ASR 5.16; 95 % CI 1.53–17.35) and a slightly elevated risk in Korea (ASR 1.20; 95 % CI 1.01–1.42) (Fig. 4). The estimate for rosiglitazone and risk of hospitalisation for heart failure in the pooled Asian population was not significant (ASR 1.24; 95 % CI 0.84–1.83). For pioglitazone there were no significant associations in Japan, Korea or Taiwan, but there was for an increase in Hong Kong. No significant association was found when results were pooled (ASR 1.06; 95 % CI 0.79–1.43) (Fig. 4). No significant association was found in any Asian country or in the pooled analysis between metformin and heart failure hospitalisation (ASR 0.96; 95 % CI 0.89–1.04) (Fig. 4).Fig. 4


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 diabetes medicine use and risk of incident heart failure hospitalisation: Asian countries. CI confidence interval, Japan I Japan Medical Data Centre insurance claims database, IV inverse variance, SE standard error
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: Sequence symmetry analysis results for incident diabetes medicine use and risk of incident heart failure hospitalisation: Asian countries. CI confidence interval, Japan I Japan Medical Data Centre insurance claims database, IV inverse variance, SE standard error
Mentions: No significant risk was observed for rosiglitazone use and heart failure hospitalisation in Taiwan; however, a significantly elevated risk was observed in Hong Kong (ASR 5.16; 95 % CI 1.53–17.35) and a slightly elevated risk in Korea (ASR 1.20; 95 % CI 1.01–1.42) (Fig. 4). The estimate for rosiglitazone and risk of hospitalisation for heart failure in the pooled Asian population was not significant (ASR 1.24; 95 % CI 0.84–1.83). For pioglitazone there were no significant associations in Japan, Korea or Taiwan, but there was for an increase in Hong Kong. No significant association was found when results were pooled (ASR 1.06; 95 % CI 0.79–1.43) (Fig. 4). No significant association was found in any Asian country or in the pooled analysis between metformin and heart failure hospitalisation (ASR 0.96; 95 % CI 0.89–1.04) (Fig. 4).Fig. 4

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