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Comparing Medications for Adults With Type 2 Diabetes

Slide: 33 of 35

Comparative Effectiveness and Safety in Subpopulations

Twenty-eight studies (21 RCTs and 7 cohort studies) addressed medication effectiveness and safety in subpopulations. When compared to men, women taking rosiglitazone either as monotherapy or in combination were at higher risk for bone fractures than were those taking metformin alone or in combination with sulfonylureas. However, for the majority of comparisons, the available studies did not have sufficient power to allow for subgroup analyses, and few studies occurred exclusively in a subpopulation. Three studies focused on a specific population for the study and the others conducted subgroup analyses of larger clinical trials or cohorts. The majority of trials evaluated differences in the outcome of glycemic control by baseline HbA1c. Other trial outcomes included weight gain, nephropathy, fractures, and congestive heart failure. The cohort study outcomes focused on mortality and congestive heart failure. None of the studies conducted subgroup analyses on adverse events or mortality by age. There was no conclusive information to predict which subgroups of patients might differentially respond to alternative treatments.