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2 Diabetes Drugs Double Fracture Risk in Women
Date:12/10/2008

Both Avandia and Actos lower bone density, new analysis shows

WEDNESDAY, Dec. 10 (HealthDay News) -- Two widely prescribed diabetes drugs, Avandia and Actos, double the risk of fractures in women but not in men, a new British analysis finds.

Avandia (rosiglitazone) and Actos (pioglitazone) are used to lower blood sugar in patients with type 2 diabetes. Recent studies have suggested that the risk for heart failure, death and heart attack were increased with Avandia, touching off a controversy that resulted in new U.S. Food and Drug Administration-mandated label warnings about the drug.

"Women who are taking these drugs should reconsider the options," said lead researcher Dr. Yoon Loke, a clinical senior lecturer at the University of East Anglia in Norwich. "There are quite a lot of choices for women with type 2 diabetes. I am not sure that taking a drug that causes fractures is the best choice."

There are about 4 million people in the United States who take these drugs, which are called thiazolidinediones, Loke noted.

The report was published in the Dec. 10 online issue of the Canadian Medical Association Journal.

For the meta-analysis, Loke's team evaluated 10 trials that included 13,715 diabetics taking Avandia, Actos, or neither drug. The studies found that these drugs reduced bone density in the spine and hips of women taking these medications.

Loke's group estimated this loss of bone density would double the risk of fractures in women taking either drug. For women already at risk for fractures, the researchers estimated one fracture would occur for every 21 women, and for those at low risk for fractures, one fracture would occur in 55 women taking these drugs.

However, no effect on bone density among men was seen in any of the studies the researchers analyzed.

Loke speculates that women are affected because of an interaction between the drugs and estrogen
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