September 26, 2007 – The drug Avandia®, prescribed for nearly seven million patients suffering from type 2 diabetes, is still in the hot seat. It would increase the risk of suffering a myocardial infarction by 42% and the risk of suffering from heart failure by 50%. These data come from a recent study published in the prestigious Journal of the American Medical Association (JAMA).
Authorized in 2002, Avandia (rosiglitazone) would help improve blood sugar by increasing insulin sensitivity. According to the researchers’ results, for every 220 diabetics treated with roziglitazone for one year, one diabetic will experience a heart attack associated with this drug and nearly eight will suffer from heart failure.
This is not the first time that Avandia has been suspected of causing such side effects. In June 2007, the New England Journal of Medicine sounded the alarm by publishing an analysis of 42 clinical trials. Based on the results, rosiglitazone may have adverse effects on cardiovascular health, but the magnitude of these effects remains uncertain.
The following month, the Food and Drug Administration (FDA) gathered 23 experts to advise it on whether or not to continue to authorize the sale of this drug. Twenty of them recognized that rosiglitazone poses a risk to cardiovascular health. Despite everything, 22 people voted to keep the Avandia on the market. The benefits for diabetics outweigh the risks3, they concluded.
The meta-analysis just published by JAMA could call this decision into question. The researchers, this time, analyzed the results of four trials of longer duration (at least one year) and in which the follow-up concerning cardiovascular disorders was better assured.
The results of another meta-analysis3, also published in the latest issue of JAMA, indicate that the Actos® (pioglitazone), a medicine in the same class as Avandia® (glitazones), would significantly reduce the risk of cardiovascular accident and death (18%). However, it also increases the risk of suffering from heart failure (40%). Note that this last study was funded by the company that manufactures pioglitazone.
Pierre Lefrançois – PasseportSanté.net
According to AFP and HealthDay News
1. Singh S, Loke YK, Furberg CD. Long-term risk of cardiovascular events with rosiglitazone: a meta-analysis. JAMA. 2007 Sep 12; 298 (10): 1189-95.
2. Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007 Jun 14; 356 (24): 2457-71.
3. Lincoff AM, Wolski K et al. Pioglitazone and risk of cardiovascular events in patients with type 2 diabetes mellitus: a meta-analysis of randomized trials. JAMA. 2007 Sep 12; 298 (10): 1180-8.
