Is Rosiglitazone use associated with an increase in intensive eye treatment in diabetic patients? A community based study

• Published in: The European journal of general practice Vol. 17; no. 4; pp. 205 - 209
• Main Authors: Shani, Michal, Feldman, Leonid, Kaiserman, Igor, Dresner, Julian, Baevsky, Tuvia, Vinker, Shlomo
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.12.2011; Taylor & Francis
• Subjects: Aged; Cohort Studies; diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetic Retinopathy - pathology; Diabetic Retinopathy - therapy; Female; Follow-Up Studies; Glycated Hemoglobin A - metabolism; Humans; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Laser Therapy - methods; laser treatment; Lasers, Gas - therapeutic use; Male; Middle Aged; primary care; Retrospective Studies; Rosiglitazone; Thiazolidinediones - adverse effects; Thiazolidinediones - therapeutic use; Time Factors; vitrectomy; Vitrectomy - methods
• ISSN: 1381-4788; 1751-1402
• DOI: 10.3109/13814788.2011.590191

Abstract Objective: To evaluate the effect of rosiglitazone on diabetic retinopathy in the usual care setting. Methods: Type 2 diabetic patients, aged over 40, who received rosiglitazone therapy for at least one year during the study period, were considered for the study group. All diabetic patients who had never received rosiglitazone or insulin were candidates for the control group. For each subject treated with rosiglitazone, up to five controls were randomly selected and matched on age, gender, and HbA1c%. We retrieved information about ophthalmologist visits, retinal argon laser therapy, vitrectomy and the date of the procedure. Time from the first rosiglitazone prescription to the first intervention was calculated. Results: A total of 6689 subjects, 1304 in the rosiglitazone group and 5385 in the control group were followed for a median of 3.6 years. The baseline level of HbA1C% was slightly higher in the rosiglitazone group (9.2 versus 8.8). There were more ophthalmologist visits in the rosiglitazone group compared to the control group. 115/1304 (8.8%) patients in the study group had an event compared to 379/5385 (7.0%) control group (P = 0.027). HR for the study group was 1.3 (95% CI: 1.08-1.64) for any event compared to control group (P = 0.008). Conclusion: Rosiglitazone was associated with increased laser treatments and vitrectomy. Caution may be needed when treating diabetic patients with rosiglitazone.