New Data Supports Link Between Diabetes Drugs, Fractures

Avandia, Actos increase chances of broken bones in older men and women, study shows

By Amanda Gardner
HealthDay Reporter

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THURSDAY, July 29 (HealthDay News) -- New research finds that two widely prescribed diabetes drugs may raise the risk of broken bones in postmenopausal women with type 2 diabetes.

There was also a fracture risk seen among men who had been prescribed either Avandia or Actos plus a loop diuretic.

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This isn't the first time such an association has been seen, raising doubts as to whether these drugs, which belong to the class of medications known as thiazolidinediones (TZDs), should be the first choice for treating type 2 diabetes.

"This raises the question of whether this class of drugs is best for patients. There are a lot of other great drugs you can use in diabetes, the best of which is to give patients insulin, which has no real side effects and has been used for 80 years," observed Steve Hammes, chief of endocrinology at the University of Rochester Medical Center. "It's more and more clear that, as a first-line agent, TZDs are probably not a good idea."

"This has been my worst worry for the longest time," added Dr. Mary Ann Banerji, director of the Diabetes Treatment Center at the State University of New York (SUNY) Downstate Medical Center in New York City. "Also, what about loop diuretics? We use all of these things, and the issue we should really be thinking through is what about other drugs we can use? What's the risk benefit?"

The findings may skew physicians away from both drugs, but especially Avandia, said Hammes.

Earlier this summer, a U.S. Food and Drug Administration advisory committee dealt rosiglitazone (Avandia) a blow when it concluded that Avandia raises the risk of heart attack and should only stay on the market with tightened controls.

Pioglitazone (Actos), on the other hand, has not been associated with an increased cardiac risk.

But the fracture risk in both drugs has been seen before and is already included in the labeling for the medications.

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