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Avandia Raises Risk of Heart Failure, Fractures
Date:6/5/2009

art failure but that is within the context of, if anything, less death and no increase in overall cardiovascular disease," Home said. "Something is balancing it out, and it may well be the reduction in the risk of stroke."

The heart attack data was not conclusive, although the fracture rate, at least in women, was significantly higher among those taking Avandia.

Recommendations issued earlier this year had removed Avandia from the list of drugs doctors should consider using, Dr. David Nathan, chairman of the consensus committee that released that document, said during the news conference. "I think we will take this data back to our committee and discuss it. We will go back and reconsider."

Even if doctors decide to try prescribing the drug again (its usage dropped in large numbers after the 2007 meta-analysis by Nissen), figuring out which patients with type 2 diabetes shouldn't be taking Avandia may be difficult, said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City.

"These patients are already at risk for heart disease. How do you select or omit patients because they are all at risk for heart disease because of their diabetes? Heart failure and fractures are processes that we are already trying to prevent in this population."

More information

Find out more about type 2 diabetes at the American Diabetes Association.



SOURCES: Steven E. Nissen, M.D., chairman, department of cardiovascular medicine, Cleveland Clinic Foundation; Carl J. Lavie, M.D., medical director, cardiac rehabilitation, and prevention director, Stress Testing Laboratory, Ochsner Heart and Vascular Institute, New Orleans; Suzanne Steinbaum, D.O., director, women and heart disease, Lenox Hill Hospital, New York City; June 5, 2009, teleconference with Philip D. Home, D.M., D.Phi
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