Diabetes Drugs and Heart Risk
New Studies Link Avandia, but Not Actos, to Heart Attacks
WebMD News Archive
GSK Disputes Avandia Findings continued...
"The evidence confirms a significantly increased risk of heart attack
with [Avandia] and a doubling in the risk of heart failure compared to other
oral [blood sugar-reducing] agents," Singh tells WebMD. "We are waiting
for clinical trial evidence suggesting that [Avandia] use leads to a reduction
in the morbidity and mortality in patients with type 2 diabetes. Until such
evidence becomes available, we stand by our statement that [Avandia] should not
be used in diabetic patients at risk for cardiovascular events."
Clinical trials have not yet demonstrated a clear survival benefit or
reduction in diabetes complications for patients taking Avandia. But they do
show that Avandia helps people with diabetes control their blood sugar.
"We know from clinical studies that effective treatment of diabetes
requires intensive, long-term, day-to-day control of blood sugar levels to
reduce the risk of serious complications (such as blindness, kidney
failure, limb amputation, nerve injury) and ultimately save lives," the GSK
statement says. "Avandia is the most widely studied oral medication for
type 2 diabetes, and is an important option for physicians who often need to
prescribe several different diabetes medicines in combination to help their
patients maintain blood sugar control."
Study: Actos Has Heart Attack-Stroke Benefit, Not Risk
The second JAMA study analyzes clinical trial data on Actos. It comes from
Cleveland Clinic researchers A. Michael Lincoff, MD, and colleagues --
The study shows that Actos does not increase risk of heart attack but
instead reduces diabetes patients' risk of heart attack, stroke, and death by
"We can say with confidence that Actos not only does not have the risk
seen with Avandia, but has a benefit beyond that," Lincoff tells WebMD.
"I am a cardiologist, not a diabetologist. But if a drug of this class is
thought to be a good drug for a diabetic patient, Actos has benefit beyond its
blood sugar and insulin-resistance indications for reducing death and heart
attack and stroke; all reduced about 20%."
An editorial accompanying the studies notes that the two drugs have
"strikingly different" effects on heart attack risk. Editorialist
Daniel H. Solomon, MD, PhD, is associate professor of medicine at Harvard
Medical School and a rheumatologist in the division of pharmacoepidemiology at
Brigham and Women's Hospital, Boston.