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  • Title: A comparison of select cardiovascular outcomes by antidiabetic prescription drug classes used to treat type 2 diabetes among Military Health System beneficiaries, fiscal year 2003-2006.
    Author: Casscells SW, Granger E, Swedorske J, Goldhammer R, Shaheen M, Dorris J, Hong A, Wiktor M.
    Journal: Am J Ther; 2008; 15(3):198-205. PubMed ID: 18496256.
    Abstract:
    BACKGROUND: Recent research suggests that there is an increased risk of cardiovascular outcomes among individuals with type 2 diabetes taking rosiglitazone (Avandia). OBJECTIVE: To determine if there is an increased incidence of select cardiovascular events, specifically acute myocardial infarction (AMI) and congestive heart failure (CHF), among Military Health System beneficiaries with type 2 diabetes who filled a prescription for Avandia compared with those who filled prescriptions for other antidiabetic medications. DESIGN: Cross-sectional analysis of data from fiscal year 2003-2006. PARTICIPANTS: Military Health System beneficiaries who are enrolled in TRICARE Prime [Health Maintenance Organization (HMO)-like option] with a diagnosis of type 2 diabetes. RESULTS: Average annual incidence of AMI and CHF was lowest among individuals who filled a prescription for biguanides (metformin) and greatest among those who filled a prescription for insulin. The incidence of AMI was highest among beneficiaries with a triple combination of antidiabetic drugs including insulin. The incidence of CHF was highest among those who took a sulfonylurea and Actos during the observation period (fiscal year 2003-2006). LIMITATIONS: This study has several limitations including the cross-sectional design and inability to make statistical comparisons across drug categories. CONCLUSIONS: There does not appear to be an increased annual incidence of AMI or CHF among TRICARE Prime beneficiaries with a diagnosis of type 2 diabetes who have filled a prescription for Avandia compared with those who filled prescriptions for other antidiabetic medications.
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