Letters Warfarin plus sulfonylureas and serious hypoglycemic events

Authors’ reply to Bosco-Lévy and Salvo

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i4330 (Published 05 August 2016) Cite this as: BMJ 2016;354:i4330
  1. John A Romley, economist and associate professor (research)1 2,
  2. Cynthia Gong, doctoral student3,
  3. Anupam B Jena, assistant professor4,
  4. Dana P Goldman, director and professor and Leonard D Schaeffer chair1 5 4,
  5. Bradley Williams, professor6,
  6. Anne Peters, professor of medicine7
  1. 1Leonard D Schaeffer Center for Health Policy and Economics
  2. 2Price School of Public Policy, University of Southern California, 635 Downey Way, Los Angeles, CA 90089-3333, USA
  3. 3School of Pharmacy, University of Southern California, 635 Downey Way, Los Angeles, CA 90089-3333, USA
  4. 4Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA
  5. 5Price School of Public Policy, School of Pharmacy, and Dornsife College of Letters, Arts and Sciences, University of Southern California, 635 Downey Way, Los Angeles, CA 90089-3333, USA
  6. 6School of Pharmacy, University of Southern California, Health Sciences Campus, Los Angeles, CA 90089-9121, USA
  7. 7Keck School of Medicine, University of Southern California, 150 N Robertson Blvd, Suite 210, Beverly Hills, CA 90211, USA
  1. romley{at}healthpolicy.usc.edu

We thank Bosco-Lévy and Salvo for their comments,1 2 and we deal with each in turn.

Warfarin dosing is hard to measure in a claims database (because of important interaction with patient physiology), but glipizide/glimepiride dosing is more readily assessed. Bosco-Lévy and Salvo are correct that hypoglycemia risk increases with dose. Our findings reflect low and high dose users, and future research should …

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