Diabetes Drugs May Help Fight Inflammation
Newer Drugs May Lower Heart Disease Risk by Fighting Inflammation
June 20, 2005 -- There is growing evidence that a specific class of may help fight heart
disease by also fighting inflammation.
In recent years research has pointed to inflammation as a possible cause of
heart disease. And early studies have hinted that the drugs Actos and Avandia may help fight heart disease not
only by improving blood sugar but also by battling inflammation.
Actos and Avandia belong to the relatively new class of drugs known as
thiazolidinediones, or TZDs. They improve blood sugar by reducing insulin
resistance, a hallmark of type 2 diabetes. This occurs when the body does not
respond as well to the blood-sugar-lowering effects of the hormone insulin.
In a newly published study, researchers compared Actos with an older type of
diabetes drug that lowers blood sugar in an entirely different way and does not
reduce insulin resistance.
The studies included results of 173 patients who took either Actos or Amaryl
for six months.
Both drugs worked equally well to control blood sugar. But Actos also
improved several heart disease risk factors, including cholesterol and markers
of inflammation, such as
Carotid artery wall thickness, a measure of arteries that supply the brain
and an indicator of heart disease, also improved with Actos.
These benefits were not seen in the patients who took Amaryl.
The research was funded by Actos manufacturer Takeda Pharma, and is
published in the June 21 issue of the Journal of the American College of
"This is one more bit of provocative information suggesting that TZDs
may be a very useful class of drugs for preventing heart disease," American
Diabetes Association (ADA) president Robert Rizza, MD, tells WebMD.
"We won't know for sure, though, until we see the results from ongoing
studies examining the question."
Heart Disease, Stroke Leading Causes of Death
Heart disease and stroke are the leading causes of death among people with
diabetes, with two out of three diabetes patients eventually dying from one of
According to one the new study's researchers, it makes sense that the TZDs
would protect against heart attack and stroke because insulin is active in the
lining of the blood vessels. The drugs' insulin-resistance properties may help
reduce inflammation within the lining of the vessels. And less inflammation may
But Andreas Pfutzner, MD, PhD, agrees that larger clinical trials are needed
to clarify the true significance of the findings.
Concerns and a Troubled Past
Because Actos and Avandia can cause fluid retention, they are not
recommended for people with moderate to severe heart failure.
In a study reported in September of 2003, University of Texas researchers
six cases of congestive heart failure among
diabetes patients taking the drugs. They concluded that people with diabetes
who have mild heart disease or any problems with their kidneys could be at
greater risk of developing heart failure if they take Actos or Avandia.
And the first TZD, sold as Rezulin, was blamed for roughly 60 deaths from
liver failure and was taken off the market in the spring of 2000. Some critics
have expressed similar concerns about the two remaining TZDs, but they are
widely considered to be safe alternatives to Rezulin.