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To the Editor: The study by Dr Nissen and colleagues¹ evaluating the incidence of death, myocardial infarction, stroke, congestive heart failure, and transient ischemic attack in patients with diabetes treated with muraglitazar underscores the need for inclusion of hard clinical end points in the evaluation of new drugs, as well as a thorough review of all available data in a peer-reviewed format. At times the presumed safety of a drug is not realized when used in higher-risk populations (eg, cyclooxygenase 2 inhibitors), and at times unexpected events may be observed in populations thought to potentially derive the most benefit from a drug. Such was the case when clopidogrel was compared with aspirin plus esomeprazole in patients at high risk for vascular events who had presented with ulcer bleeding.²

We are interested in whether a separate analysis was performed for patients receiving both a PPAR- and PPAR- agonist as 2 separate . . . [Full Text of this Article]

David Parra, PharmD, BCPS
David.Parra@med.va.gov
Veterans Affairs Medical Center
West Palm Beach, Fla

Cherylyn Beckey, PharmD
College of Pharmacy
Nova Southeastern University
Palm Beach Gardens, Fla

Thomas Thomas, MD
Veterans Affairs Medical Center
West Palm Beach

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