Loke thinks that these drugs need stronger warnings about potential side effects. "The U.S. Food and Drug Administration needs to give a much stronger warning to women. And the warning should be that really these drugs should be avoided if at all possible," he said.
Dr. Lorraine Lipscombe, from the Institute for Clinical Evaluative Sciences and the University of Toronto in Canada and author of an accompanying journal editorial, thinks this study raises more concerns about the use of these drugs.
"This evidence adds to the growing concern regarding these drugs, which have also been associated with a higher risk of heart failure, and possibly heart attacks," Lipscombe said. "Because diabetes drugs are typically approved based on their effects on sugar control rather than long-term outcomes, these adverse effects have only emerged after the drugs have been on the market."
There is still not enough evidence as to the clinical benefit of these drugs -- aside from lowering blood sugar -- therefore the use of these drugs in diabetes treatment is unclear, Lipscombe said.
"Because clinical trials are designed to assess the expected effects of drugs, they often don't have enough power to detect unexpected or less common effects," Lipscombe said. "Therefore, a more standardized post-marketing surveillance process is needed to ensure that potential adverse effects are recognized as early as possible."
GlaxoSmithKline, the maker of Avandia, said this study rehashes something which is already known and reflected on its label. In addition, the company stands behinds the drug as "a safe and effective treatment for type 2 diabetes for the appropriate patient."
"The association with thiazolidinediones on bon
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