Navigation Links
Avandia Raises Heart Failure Risk More Than Actos
Date:8/18/2009

Diabetes drug shouldn't be used when there's a safer alternative, study says

TUESDAY, Aug. 18 (HealthDay News) -- The type 2 diabetes drug Avandia (rosiglitazone) increases the risk of heart failure and death more than another drug in the same class, Actos (pioglitazone), new Canadian research contends.

Avandia has been the subject of controversy since 2007, when it was linked to an increased risk for heart attack and death, although those claims have become clouded as other studies have discounted that risk to some degree. But taken together, many believe that the drug should not be used, especially since there appears to be a safer choice.

"It is difficult for making a case for using rosiglitazone in anybody, because we have an alternative," said lead researcher Dr. David Juurlink, division head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto.

In 2007, Dr. Steven Nissen, chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic, published a study that found Avandia showed a 43 percent greater risk of heart attack among diabetes patients, and he remains convinced that the drug should not be used.

"I agree with the authors' conclusions," Nissen said. "Rosiglitazone should not be used in patients with diabetes. Pioglitazone is a safer alternative."

There is increasing evidence that Actos is safer than Avandia, Juurlink said. "Not a single study has suggested that pioglitazone might be less safe than rosiglitazone," he said. "And rosiglitazone doesn't have a single advantage -- not even a theoretical one."

Both Avandia and Actos belong to a class of drugs called thiazolidinediones, which are used widely to lower blood sugar in people with type 2 diabetes. In addition to an increased risk for heart failure, both drugs can also cause side effects that include weight gain and fluid retention. Both medications carry a U.S. Food and Drug Administration warning label about the risk of heart failure and heart attack.

The latest report on the safety of these drugs is published online Aug. 19 in the BMJ.

For the study, Juurlink's team collected data on 39,736 patients treated with Avandia or Actos between April 2002 and March 2008. The researchers compared these data with hospital records of heart failure, heart attack and deaths.

The researchers found that patients taking Avandia were at greater risk of heart failure and death than those taking Actos. There was no significant difference between the drugs for the risk of heart attack, Juurlink's group noted.

For every 93 patients treated with Avandia instead of Actos, there was one additional cardiovascular event or death per year, the researchers estimated.

"As a clinician, I cannot envision an instance in which I would recommend rosiglitazone," Juurlink said.

However, Corinne de Vries, a professor of pharmacoepidemiology in the department of pharmacy and pharmacology at the University of Bath, England, and co-author of an accompanying journal editorial, is not convinced that Avandia is less safe than Actos.

"Nobody should stop taking their medication without consulting their doctor, because I don't think rosiglitazone kills you," de Vries said.

De Vries said the conclusions of this study are not supported by the data Juurlink's group used. People taking Avandia were sicker than those taking Actos, so these patients were more likely to develop heart failure, she noted.

"The data presented by Juurlink do not support the suggestion that you should favor one drug over the other," de Vries said. "There is no reason to believe yet that there is a difference."

People who have a preexisting heart condition should not be started on either of these drugs, de Vries stressed. Patients who develop heart failure should have the drug discontinued, because the condition is usually reversible, she added.

Another expert, Dr. Carl J. Lavie, medical director for cardiac rehabilitation and prevention director of the Stress Testing Laboratory at the Ochsner Heart and Vascular Institute in New Orleans, thinks the study gives more reasons not to use Avandia.

"I believe that most clinicians have stopped using Avandia -- some will use Actos instead or go to another class completely," Lavie said.

Lavie noted that an ongoing study assessing Avandia and Actos in a head-to-head comparison should provide more answers about these drugs.

"Until then, this current study provides further ammunition against using Avandia or at least for trying Actos first, which is along the same lines as the current American Diabetes Association and European guidelines anyway," Lavie said. "Most will, and should, avoid either agent in a patient with heart failure or high heart failure risk."

"Both drugs have a place in treating diabetes, but not if you have a preexisting heart condition," de Vries said.

More information

For more information on diabetes, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.



SOURCES: David Juurlink, M.D., Ph.D., Division Head, Clinical Pharmacology and Toxicology, Sunnybrook Health Sciences Centre, Toronto; Steven E. Nissen, M.D., chairman, Department of Cardiovascular Medicine, Cleveland Clinic, Ohio; Corinne de Vries, Ph.D., professor, pharmacoepidemiology, Department of Pharmacy and Pharmacology, University of Bath, England; Carl J. Lavie, M.D., medical director, cardiac rehabilitation, and prevention director, Stress Testing Laboratory, Ochsner Heart and Vascular Institute, New Orleans; Aug. 19, 2009, BMJ, online


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Avandia Raises Risk of Heart Failure, Fractures
2. Avandia Attorney Says Study Based on Useless Trick Science
3. Halting Avandia Use Hikes Blood Sugar Levels
4. LegalView Updates Avandia Information Portal With New Articles Detailing Potentially Dangerous Side Effects
5. Avandias Heart Risk Higher Than Others in Its Class
6. Public Citizen Petitions FDA to Ban Diabetes Drug Avandia, According to Avandia Plaintiffs Attorney Group
7. Consumer Group Seeks FDA Ban on Avandia
8. LegalView Re-Launches its Avandia Information Portal with News of the Type 2 Diabetes Drug's Risks and Dangers
9. Concern From Doctors Regarding the Cardiovascular Safety of GlaxoSmithKlines Avandia Increases Nine-Fold Following Publication of Meta-Analysis
10. Avandia May Slow Atherosclerosis After Bypass Surgery
11. Older Diabetics Using Avandia Face Increased Death Risk
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Avandia Raises Heart Failure Risk More Than Actos
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary of ... award to iHire in recognition of their exemplary accomplishments in worksite health promotion. , ... Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was ...
(Date:6/24/2016)... ... , ... Those who have experienced traumatic events may suffer from a complex ... as drug or alcohol abuse, as a coping mechanism. To avoid this pain and ... a traumatic event. , Trauma sufferers tend to feel a range of emotions, from ...
(Date:6/24/2016)... ... June 24, 2016 , ... The Pulmonary Hypertension ... that it will receive two significant new grants to support its work to ... its 25th anniversary by recognizing patients, medical professionals and scientists for their work ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Comfort Keepers® of ... Cancer Society and the Road To Recovery® program to drive cancer patients to and ... other adults to ensure the highest quality of life and ongoing independence. Getting ...
(Date:6/24/2016)... ... June 24, 2016 , ... EB Medicine ... Making in Emergency Medicine conference in Ponte Vedra Beach, FL. The awards honor ... Emergency Medicine Practice and Pediatric Emergency Medicine Practice. , “With this ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 2016   Pulmatrix, Inc ., (NASDAQ: ... drugs, announced today that it was added to the ... its comprehensive set of U.S. and global equity indexes ... important milestone for Pulmatrix," said Chief Executive Officer ... our progress in developing drugs for crucial unmet medical ...
(Date:6/23/2016)...  MedSource announced today that it has selected ... of choice.  This latest decision demonstrates MedSource,s commitment ... clients by offering a state-of-the-art electronic data capture ... as the EDC platform of choice in exchange ... has long been a preferred EDC platform by ...
(Date:6/23/2016)... June 23, 2016 Research and ... Excipients Market by Type (Organic Chemical (Sugar, Petrochemical, Glycerin), ... Topical, Coating, Parenteral) - Global Forecast to 2021" ... The global pharmaceutical excipients market is projected ... CAGR of 6.1% in the forecast period 2016 to ...
Breaking Medicine Technology: