Cardiovascular Effects of Diabetes Drugs: Making the Dark Ages Brighter With CAROLINA
Authors: Julio Rosenstock
Journal: Annals of Internal Medicine (2013)

Letters19 March 2013Cardiovascular Effects of Diabetes Drugs: Making the Dark Ages Brighter With CAROLINAJulio Rosenstock, MD, Nikolaus Marx, MD, Odd-Erik Johansen, MD, PhD, and Hans-Jürgen Wörle, MD, on behalf of the CAROLINA Steering CommitteeJulio Rosenstock, MDFrom Dallas Diabetes & Endocrine Center at Medical City, Dallas, Texas; University Hospital Aachen, Aachen, Germany; and Boehringer Ingleheim, Ingelheim, Germany.Search for more papers by this author, Nikolaus Marx, MDFrom Dallas Diabetes & Endocrine Center at Medical City, Dallas, Texas; University Hospital Aachen, Aachen, Germany; and Boehringer Ingleheim, Ingelheim, Germany.Search for more papers by this author, Odd-Erik Johansen, MD, PhDFrom Dallas Diabetes & Endocrine Center at Medical City, Dallas, Texas; University Hospital Aachen, Aachen, Germany; and Boehringer Ingleheim, Ingelheim, Germany.Search for more papers by this author, and Hans-Jürgen Wörle, MDFrom Dallas Diabetes & Endocrine Center at Medical City, Dallas, Texas; University Hospital Aachen, Aachen, Germany; and Boehringer Ingleheim, Ingelheim, Germany.Search for more papers by this author, on behalf of the CAROLINA Steering CommitteeSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-6-201303190-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Nissen's recent editorial (1) on Roumie and colleagues' study (2) with great interest. We agree entirely with Nissen that the evidence base to guide clinical decision making in type 2 diabetes mellitus currently suffers from the absence of a rigorous, randomized, controlled trial (RCT) that addresses the sulfonylurea controversy. Not only are there conflicting results between older and more recent trials using sulfonylureas, but observational studies also are not concordant (2, 3). Indeed, even with the best biostatistics and methods, no epidemiologic, observational retrospective, or prospective cohort study can replace a properly conducted RCT.Nissen ...References1. Nissen SE. Cardiovascular effects of diabetes drugs: emerging from the dark ages. Ann Intern Med. 2012;157:671-2. [PMID: 23128866] LinkGoogle Scholar2. Roumie CL, Hung AM, Greevy RA, Grijalva CG, Liu X, Murff HJ, et al. Comparative effectiveness of sulfonylurea and metformin monotherapy on cardiovascular events in type 2 diabetes mellitus: a cohort study. Ann Intern Med. 2012;157:601-10. [PMID: 23128859] LinkGoogle Scholar3. Zeller M, Danchin N, Simon D, Vahanian A, Lorgis L, Cottin Y, et al; French Registry of Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction investigators. Impact of type of preadmission sulfonylureas on mortality and cardiovascular outcomes in diabetic patients with acute myocardial infarction. J Clin Endocrinol Metab. 2010;95:4993-5002. [PMID: 20702526] CrossrefMedlineGoogle Scholar4. Nathan DM. Time for clinically relevant comparative effectiveness studies in type 2 diabetes [Editorial]. Ann Intern Med. 2011;154:131-2. [PMID: 21135287] LinkGoogle Scholar5. Bennett WL, Maruthur NM, Singh S, Segal JB, Wilson LM, Chatterjee R, et al. Comparative effectiveness and safety of medications for type 2 diabetes: an update including new drugs and 2-drug combinations. Ann Intern Med. 2011;154:602-13. [PMID: 21403054] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Julio Rosenstock, MD; Nikolaus Marx, MD; Odd-Erik Johansen, MD, PhD; Hans-Jürgen Wörle, MDAffiliations: From Dallas Diabetes & Endocrine Center at Medical City, Dallas, Texas; University Hospital Aachen, Aachen, Germany; and Boehringer Ingleheim, Ingelheim, Germany.Disclosures: All authors are involved in the CAROLINA Steering Committee. Dr. Rosenstock has also served on scientific advisory boards and received honorarium or consulting fees from Pfizer, Roche, Sanofi, Novo Nordisk, Eli Lilly, MannKind, GlaxoSmithKline, Takeda, Daiichi Sankyo, Johnson & Johnson, Novartis, Boehringer Ingelheim, and Lexicon. He has also received grants/research support from Merck, Pfizer, Sanofi, Novo Nordisk, Roche, Bristol-Myers Squibb, Eli Lilly, Forest, GlaxoSmithKline, Takeda, Novartis, AstraZeneca, Amylin, Johnson & Johnson, Daiichi Sankyo, MannKind, Lexicon, and Boehringer Ingelheim. Dr. Marx served as a speaker for AstraZeneca, Bayer, Bristol-Myers Squibb, Boehringer Ingelheim, Cordis, GlaxoSmithKline, Lilly, Merck Sharpe & Dohme, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi, and Takeda and as a consultant for AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Genfit, GlaxoSmithKline, Merck Sharpe & Dohme, Novo Nordisk, Roche, Sanofi, and Takeda. He received unrestricted research grants from Boehringer Ingelheim, GlaxoSmithKline, Merck Sharpe & Dohme, and Takeda and also participated in clinical trials sponsored by Boehringer Ingelheim and Roche. Drs. Johansen and Wörle are employed by Boehringer Ingelheim. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparative Effectiveness of Sulfonylurea and Metformin Monotherapy on Cardiovascular Events in Type 2 Diabetes Mellitus Christianne L. Roumie , Adriana M. Hung , Robert A. Greevy , Carlos G. Grijalva , Xulei Liu , Harvey J. Murff , Tom A. Elasy , and Marie R. Griffin Cardiovascular Effects of Diabetes Drugs: Emerging From the Dark Ages Steven E. Nissen Metrics Cited byFDA guidance on antihyperglyacemic therapies for type 2 diabetes: One decade laterManaging Chronic Coronary Artery Disease in Patients with DiabetesSmoke or Fire? Acute Pancreatitis and the Liraglutide Trials 19 March 2013Volume 158, Issue 6Page: 499KeywordsCardiovascular therapyClinical trialsDecision makingDrugsEpidemiologyForecastingObservational studiesResearch grantsType 2 diabetes ePublished: 19 March 2013 Issue Published: 19 March 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...