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FDA Reviewer Questions Results of Key Avandia Trial
Date:7/11/2010

study was conducted according to good clinical practices and the data are reliable. . . RECORD demonstrated that Avandia was not associated with an overall increase in cardiovascular hospitalization or cardiovascular death compared to metformin and sulfonylureas."

But Dr. Kirk Garratt, clinical director of interventional cardiovascular research at Lenox Hill Hospital in New York City, said Friday, "If the data from RECORD had truly been mishandled in some way, not only is it going to pretty well be the end of Avandia in the clinical world, but it's going to put GlaxoSmithKline under the magnifying glass in an important way for clinicians going forward. They'll lose credibility, and that's tough to get back."

"There is an alternative drug out there," Garratt added. "From the clinical side, it's a fortunate circumstance that we find ourselves in, since we have an alternative product that seems to have [little] risk associated with it."

Actos (pioglitazone), made by Takeda, is in the same pharmaceutical class as Avandia. Both are medications known as thiazolidinediones (TZDs), which are blood-sugar-lowering drugs. Both are used by type 2 diabetics.

"The bulk of studies have suggested that Avandia is associated with greater cardiovascular mortality than the alternative, which is pioglitazone," noted Dr. Ronald Goldberg, a professor of medicine at the University of Miami Miller School of Medicine, on Friday.

This is only the latest in a series of conflicting information about Avandia's heart risks. In November of 2007, the FDA added a boxed warning to the drug, saying that there was a potential risk of increased cardiovascular ischemic events. Patients also began receiving a medication guide explaining the risks.

But just last week, three studies emerged with conflicting conclusions about the drug's safety. Two of them, published in major medical journals, found that Avandia did raise heart risks, while the third, released at th
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