Appropriatezza d'impiego dei tiazolidindioni nell'Azienda Ospedaliera di Ferrara

Introduction. The risk-benefit profile of thiazolidinediones (TZDs), oral hypoglycaemic agents has been recently widely discussed in literature. As second-line treatment of type 2 diabetes their reimbursement has been associated in the ER Region to a treatment plans (TP), whose data allow the assessment of appropriateness, effectiveness, safety. Methods. The TP data were analyzed on the following parameters: age and sex of patients, TZD prescribed, other antidiabetic drugs, Hb1Ac and BMI values in first prescription, Hb1Ac value in following prescriptions, any major complications. Results. The investigation has been conducted on 788 PT, for 448 patients(mean age 65.7 yrs, 59% men), from April 2008 to November 2009. Up to 78.8% of first prescriptions were for pioglitazone, and 67.2% for metformin and sulphonylurea. The Hb1Ac and BMI values, in the first prescription, were respectively > 7% in 71.4% and ≥25 kg/m2 in 79% patients. Only in ¼ of the 49.3% of patients follow-up measures, HB1/Ac decreased. Complications were reported in 10.5% of pts, with a prevalence of cardiovascular events (3.2% for rosiglitazone, 2.7% for pioglitazone). Conclusion. The results show an adherence to the international guidelines criterias and to the labelled therapeutic indications for glitazones' prescription. Glitazones therapy seems to be effective in a quarter of patients and seems to be relatively safe; TPs provide an useful tool to monitor therapy safety, and effectiveness in diabetic patients.