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Changes in Glitazone Use 2003-2009

Changes in Glitazone Use 2003-2009: From 2003 through 2005, glitazone use increased steadily. From February 2005 to January 2007, rosiglitazone use decreased by 16% annually while pioglitazone use increased at an annual rate of 14%. During a period of FDA advisories, rosiglitazone use declined sharply from 0.42 million monthly treatment visits to 0.13 million monthly visits. Pioglitazone use remained stable, accounting for ~5.8 million physician visits (77% of all glitazone use) where a treatment was used during the final 12 months of observation. The combined effect of scientific publications, advisories, and media exposure was associated with a substantial decrease in rosiglitazone use. Despite a class-level FDA advisory, pioglitazone use was not similarly affected. The potential risks of the glitazones, relative to other available agents (e.g., sulfonyureas, biguanides), also suggests their limited role as monotherapy for diabetes or use in patients at elevated risk of congestive heart failure or ischemic heart disease.