Comparative risk of severe hypoglycemia among concomitant users of thiazolidinedione antidiabetic agents and antihyperlipidemics. (May 2016)

• Record Type: Journal Article
• Authors: Leonard, Charles E.; Han, Xu; Bilker, Warren B.; Flory, James H.; Brensinger, Colleen M.; Flockhart, David A.; Gagne, Joshua J.; Cardillo, Serena; Hennessy, Sean
• Is Part Of: Diabetes research and clinical practice. Volume 115(2016)
• Page Start: 60
• Page End: 67
• Publication Date: 2016-05
• Subjects: Cohort studies -- Drug interactions -- Hypoglycemia -- Medicaid -- Pharmacoepidemiology -- Thiazolidinediones; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2016.03.006
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Concomitant thiazolidinedione + fibrate use was associated with a ∼1.5- to 2.5-fold increased risk of severe hypoglycemia. This increased risk generally manifested after the first month of concomitant use. Severe hypoglycemia occurs in some patients receiving a thiazolidinedione, even without concomitant exposure to insulin or a sulfonylurea. The apparent drug interaction between thiazolidinediones and fibrates is an underappreciated cause of severe hypoglycemia. Clinicians should be attuned to both immediate- and delayed-onset hypoglycemia in their patients treated concomitantly with thiazolidinediones and fibrates. Abstract: We conducted high-dimensional propensity score-adjusted cohort studies to examine whether thiazolidinedione use with a statin or fibrate was associated with an increased risk of severe hypoglycemia. We found that concomitant therapy with a thiazolidinedione + fibrate was associated with a generally delayed increased risk of severe hypoglycemia.