The UK Midlands Therapeutics Review and Advisory Committee (MTRAC) has reviewed the evidence on the use of rosiglitazone and pioglitazone in type 2 diabetes and updated its guidance on suitability for prescribing in general practice.
The Committee considers that rosiglitazone cannot be recommended for prescribing, based on current concerns about potential cardiovascular adverse effects, and lack of evidence for improved patient-orientated outcomes.
It considers that pioglitazone is suitable for use in primary care by a prescriber with a particular interest in type 2 diabetes who can identify patients likely to benefit from treatment, and monitor for side effect e.g. heart failure.
There is conflicting evidence whether pioglitazone is associated with long term clinical benefits or harms on cardiovascular outcomes, which dictates caution in its use.
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