Evidence mapPaperPMID 26251229Full record

ArticlePharmacoepidemiology and drug safety2015

Effects of safety warnings and risk management plan for Thiazolidinediones in Taiwan.

Jason C Hsu, Ching-Lan Cheng, Dennis Ross-Degnan, Anita K Wagner, Fang Zhang, Yea-Huei Kao Yang, Li-Ling Liu, Hsueh-Yung Tai, Ke-Hsin Chen, Po-Wen Yang and 1 more

Abstract read
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Jason C HsuSchool of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Ching-Lan ChengSchool of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Dennis Ross-DegnanDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Anita K WagnerDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Fang ZhangDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Yea-Huei Kao YangSchool of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Li-Ling LiuDivision of Drug, Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan.
Hsueh-Yung TaiDivision of Drug, Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan.
Ke-Hsin ChenDivision of Drug, Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan.
Po-Wen YangDivision of Drug, Food and Drug Administration, Ministry of Health and Welfare, Taipei, Taiwan.
Christine Y LuDepartment of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
National Cheng Kung University · TWHarvard Pilgrim Health Care · USHarvard University · USMinistry of Health and Welfare · TWTaiwan Food and Drug Administration · TW

Funding

Translational Research Core - Health Engagement & Action Translational (HEAT)P30DK092924 · KAISER FOUNDATION RESEARCH INSTITUTE · 2025 to 2025
$700k
NIDDK NIH HHS 1P30-DK092924NIDDK NIH HHS P30 DK092924
6 · The paper itself

Abstract

purposeTo evaluate changes in thiazolidinedione use and quality of prescription following safety warnings for thiazolidinediones and cardiac risk in 2007, Risk Management Plan (RMP) policy for rosiglitazone in 2010, and warning for pioglitazone and bladder cancer risk in 2010 in Taiwan.

methodsWe obtained 2003-2011 claims data from Taiwan's National Health Insurance Research Database. Using an interrupted time series design and segmented regression, we estimated changes in monthly prescribing rates for thiazolidinediones among all and prevalent diabetes patients with and without cardiovascular disease history (CV history). We also compared time to prescription of thiazolidinediones among new diabetes patients with CV history before and after each regulatory action using survival analysis.

resultsAmong prevalent patients with and without CV history, the prescribing rates of rosiglitazone decreased 36.88% and 28.92% after safety warnings in 2007 respectively. Pioglitazone prescriptions increased 13% among patients with CV history, but no changes were detected among patients without CV history. After rosiglitazone's RMP policy in 2010, large reductions in prescriptions were observed in patients with CV history (-101.67%) and those without CV history (-88.04%). Among new diabetes patients with CV history, cardiac safety warnings in 2007 significantly delayed the prescription of rosiglitazone, but no significant change was found for pioglitazone.

conclusionsThe Taiwan FDA regulatory actions for thiazolidinediones communicated possible risks of cardiac events and bladder cancer. Different safety regulatory actions had differential impacts on the use of rosiglitazone and pioglitazone and the quality use of these drugs among the high-risk patients.

Indexed as

Drug PrescriptionsPatient SafetyCardiovascular DiseasesDiabetes Mellitus, Type 2Drug UtilizationFemaleHumansMiddle AgedPharmacoepidemiologyRisk ManagementTaiwanThiazolidinedionesUrinary Bladder NeoplasmsThiazolidinedionespharmacoepidemiologyrisk management plansafety warningTaiwanthiazolidinedionetype 2 diabetes

Identifiers

PMID26251229
PMCPMC6636683
OpenAlexW2131498833

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.