NPC Archive Item: Diabetes news – safety review of glitazones; inhaled insulin discontinued.

NOTE – This is an archive post from the NPC and has not been updated since first publication. Therefore, some hyperlinks may no longer be working.
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The Medicines and Healthcare products Regulatory Agency have announced the outcome of a Europe wide safety review of the glitazones.

The review found a positive benefit-risk balance for both pioglitazone and rosiglitazone. However, the review also states that prescribing information should be updated for rosiglitazone to indicate that it should be used in patients with ischaemic heart disease only after a careful evaluation of the patient’s individual risk and that it should be used in combination with insulin only in exceptional cases and under close supervision.

Clinicians should be aware of the outcome of this review and the new cautions added to the prescribing information for rosiglitazone. Metformin and sulphonylureas remain the oral hypoglycaemics of choice, pioglitazone may be an alternative to these drugs in case of intolerance or where contraindications exist.

Inhaled insulin discontinued
Also in the diabetes sector this week, Pfizer have announced the discontinuation of Inhaled Insulin, marketed as Exubera®. This product is being discontinued for commercial reasons after making very little impact in the diabetes market. Patients who are already on treatment will need to be moved to alternative treatments in the next three months. A conversion guide from inhaled to sub-cutaneous insulin is given here.

This article is based on a blog by Matt Robinson and can be accessed at