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    Avandia: Less Risky in Younger, Healthier Patients?

    Study Finds Avandia No Riskier Than Actos, Unlike 4 Other Studies

    Aviandia Study 1 Piece of the Puzzle continued...

    Leanne Chrisman, MD, a diabetes specialist at Cleveland's University Hospitals Case Medical Center, agrees that diabetes patients have to find out what works for them as individuals.

    "Medications alter the body's chemistry, and not everybody's chemistry is exactly the same," Chrisman tells WebMD. "Some day there will be some kind of blood test that tells you which drug will work the best for you, but at this point, we can't do that."

    Instead of expecting their doctors to tell them what to do, Chrisman says patients have to work with their doctors in a constant back-and-forth. If a drug isn't doing what it's supposed to -- or has a side effect -- patients have to report back to their doctor so that they can try something else.

    And diabetes drugs, Chrisman says, are only one leg of the unbalanced three-legged stool on which diabetes patients perch. The other two legs are diet and exercise.

    "If you don't pay attention to any one of those legs, they will fall over," she says. "You can try to balance for a while, but it will fall over if you don't pay attention to what impacts you most."

    Nissen notes that there is no evidence that Avandia offers any unique benefits not seen with Actos.

    In July, an FDA advisory panel split over whether to recommend that Avandia be taken off the market. Twelve of the panel's 33 members said the drug should be withdrawn; all but three others recommended that the drug carry more severe safety warnings.

    Final action by the FDA is pending. Meanwhile, a clinical trial directly comparing Avandia and Actos is on hold while the FDA grapples with the issue of whether it can ethically continue.

    The Wertz study appears in the American Heart Association journal Circulation Cardiovascular Quality and Outcomes.

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