Dear Colleague s8

NHS Grampian Dr Mark Houliston Grampian Diabetes Managed Clinical Network Woolmanhill Hospital ABERDEEN AB25 1LD

Enquiries to Frances Philip Extension 55379 Direct Line (01224) 555379 Email to [email protected] Website www.diabetes.nhsgrampian.org 9 September 2010 Dear Colleague

I am sure that you will be well aware of the recent publicity surrounding Rosiglitazone indeed you might have had patients coming in to see you asking about this medication. The following link may be useful for you:

http://www.theheart.org/article/1120105.do

At present Rosiglitazone remains a licensed product available in the UK. However, the Grampian Diabetes MCN would at this time recommend that you audit your practice records to review all patients on Rosiglitazone and make a conscious decision as to whether you feel that each individual should continue on this treatment modality.

I remind you of the following statement taken from the Grampian Guidelines on the Management of Diabetes:

“All patients on Rosiglitazone should be reviewed and their requirements for the drug be assessed. In view of recent advice regarding avoidance of Rosiglitazone in patients with ischaemic heart disease and peripheral vascular disease, clinicians need to be confident of the absence of these before commencement and review regularly the appropriateness of continual therapy in suspected IHD or PVD. Pioglitazone would be an alternative agent or a DPP IV may also be considered. It may also be appropriate to consider insulin therapy at this stage.”

This position statement will be reviewed with the outcome of the European Medicines Agency deliberations.

Kind regards Yours sincerely

Mark Houliston Clinical Lead MCN for Diabetes PS

It has been brought to my attention that the link I gave will not open without a password. A quick shortcut at present is to do a Google search on "Rosiglitazone news" it is the top article.

Best Wishes,

Mark Houliston Clinical Lead Diabetes MCN Grampian