Thejournalofdiabetesnursing.co.uk

The European Medicines Agency This information has been echoed in position statements from a range of organisations, and specific advice on alternative regimens for authorisations for all rosiglitazone formulations individuals currently taking rosiglitazone has (Avandia® and Avandamet® in the UK). These been given by the Primary Care Diabetes Society medicines will stop being available in Europe (available at: http://bit.ly/doama1).
How this situation may affect the other TZD, Rosiglitazone, the first thiazolidinedione pioglitazone, is not known, although some (TZD) to come to market, has been shrouded prescribers may believe that there is a possibility in controversy since its launch in 2000. As a new of a “class” effect regarding CV risk. However, class of drug, rosiglitazone (GlaxoSmithKline it should be noted that evidence to explain the [GSK], Uxbridge) claimed to reduce peripheral different CV risk profiles of rosiglitazone and insulin resistance, leading to a reduction in blood- pioglitazone, in spite of belonging to the same glucose concentration. However, 7 years later drug class, has now emerged (Rosen, 2010). In Nissen and Wolski (2007) raised concerns about addition, evidence suggests that pioglitazone the cardiovascular (CV) safety of rosiglitazone. either confers no increased CV risk or, in some recommends suspension of Avandia, At the American Diabetes Association’s 70th circumstances, protects against myocardial Scientific Sessions in Orlando this year there London. Available at: http://bit.
ly/cJiXfU (accessed 06.10.10) were rumblings of the rosiglitazone licence It is essential that we avoid a knee-jerk reaction. We must treat everyone as an individual Administration. Some 3 months later, at the and agree, with the person with diabetes, an recommendations for patients with diabetes. Diabetes Metab European Association for the Study of Diabetes appropriate treatment regimen for their needs.
36(Suppl): S4–16
conference in Stockholm, an announcement was made by the EMA that, following a complete New global injection recommendations
MaCurdy TE et al (2010) Risk of acute myocardial infarction, review of the benefit–risk profile of products On a different note, this September saw the containing rosiglitazone (Avandia®, Avandamet® launch of new global injection recommendations elderly Medicare patients treated with rosiglitazone or pioglitazone. and Avaglim®) with focus on CV safety, the for people with diabetes (Frid et al, 2010). These JAMA 304: 411–18
EMA’s Committee for Medicinal Products for are a result of various meetings within Europe to Human Use concluded that “the benefits of use the most up-to-date scientific evidence and rosiglitazone no longer outweigh its risks and consensus on best practice in injection technique.
recommended the suspension of the marketing N Engl J Med 356: 2457–71
authorisation of the medicines” (EMA, 2010).
On the same day, GSK released a statement recommendations and convert them into a UK rosiglitazone story – lessons
learned. N Engl J Med 363:
outlining that “patient safety is paramount”, version. This meeting was facilitated by the FIT (Forum for Injection Technique) board. As you l Prescribers are advised not to issue any new or will see, your own copy of the first UK injection repeat prescriptions of rosiglitazone-containing technique recommendations has been included as a supplement to this edition of JDN. l Prescribers are advised to review currently I do hope you will read this document and treated patients and switch them to suitable injectable therapy to work optimally, it must l Pharmacists are advised to refer patients to be injected using the correct technique, in the their doctor for advice on their treatment.
correct site, every time. I believe that it is up l Patients are advised to make an appointment to us, the healthcare professionals, to ensure to discuss their treatment and not to stop we are up to date so we can pass on this Consultant – Diabetes, NHS Enfield Community taking rosiglitazone without consulting their information to people with diabetes who need Journal of Diabetes Nursing Vol 14 No 9 2010

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