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Paper of the Day - Older people at greatest risk from glitazones

Older people treated with the glitazone diabetes drugs are at greatest risk of adverse events, suggest Canadian researchers.

They studied data from 159,026 type 2 diabetes patients aged over 65 years who were being treated with oral hypoglycamic drugs.

They were followed for around four years and researchers found that current users of rosiglitazone or pioglitazone as monotherapy had a 60% increased risk of congestive heart failure, a 40% increase risk of myocardial infarction and a 29% increase risk of death, compared to those on other drugs.

The authors point out that this is an age group poorly represented in glitazone trials and add: 'Our findings argue against current labelling of thiazoldinediones that warns against use only in persons at high risk of CHF, as we did not identify any subgroup of older diabetes patients who might be protected from the adverse effects of TZDs.'

JAMA 2007;298(22):2634-2643.

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