Diabetes Drug Avandia Boosts Heart Risks: Study

Another study finds a similar drug, Actos, may be a better choice, researchers say.

By Amanda Gardner
HealthDay Reporter
Tuesday, September 11, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

TUESDAY, Sept. 11 (HealthDay News) -- A controversial drug called Avandia, used by millions of diabetics to control blood sugar, greatly increases their risk of heart attack and heart failure, researchers report.

The drug does not up users' overall risk of death, however, the new study finds.

"The balance of risks and benefits has shifted, and this needs to be factored into the equation," said Dr. Sonal Singh, lead author of the study and assistant professor of internal medicine at Wake Forest University School of Medicine in Winston-Salem, N.C.

"The risk of heart failure was known but not the magnitude. A doubling of risk is substantial," Singh added. "One in 30 patients taking rosiglitazone (Avandia) over a year will have heart failure, that's very substantial. And one in 220 will have a heart attack. That's also very substantial." Patients should talk to their doctors about the potential risks and benefits of the drug, Singh said.

The study is published in the Sept. 12 issue of the Journal of the American Medical Association, as does another study, this one finding that Actos (pioglitazone), a diabetes drug in the same class as Avandia, actually reduces the risk of heart attack, stroke and death, even while it increases the risk for serious heart failure.

"This study shows that this drug, used for sugar control, provides an additional benefit of reducing cardiovascular complications," said Dr. A. Michael Lincoff, lead author of the study and vice chairman for research in the department of cardiovascular medicine at the Cleveland Clinic. "This is very strong reassurance."

It's unclear what the new conclusions mean for this class of drugs, called thiazolidinediones. Previous studies have indicated cardiovascular risks, and, in August, the FDA mandated stricter labeling, including "black-box" warnings, for the medications.

"The whole area of thiazolidinediones has been thrown wide open by all these meta-analyses," said Dr. Gregory Dehmer, professor of internal medicine at Texas A&M Health Science Center College of Medicine and director of the cardiology division at Scott & White Hospital in Temple. "For the average clinician in the street, there's a substantial amount of uncertainty, and this is magnified for patients," he said