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Heart Risks the Same With 2 Diabetes Drugs: Study

Finding conflicts with previous research that found Avandia riskier than Actos

By Amanda Gardner
HealthDay Reporter


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TUESDAY, Aug. 24 (HealthDay News) -- A new study finds that the risk of heart attacks or death after taking the glucose-lowering diabetes drugs Avandia and Actos are about the same.

This is a direct contradiction to numerous other studies that found that the risk was elevated for Avandia (rosiglitazone) but not for Actos (pioglitazone). The findings are, however, in line with some other previous studies, further muddying the picture for patients and doctors trying to select the best drug with the least side effects.

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"The rosiglitazone story gets more and more interesting and confusing. It seems every time we have a study that indicates a problem with the drug, another one finds no trouble with it," said Dr. Kirk Garratt, clinical director of interventional cardiovascular research at Lenox Hill Hospital in New York City.

In July, members of a U.S. Food and Drug Administration advisory panel recommended adding a second black-box warning to Avandia's label warning of the cardiac dangers, while essentially clearing Actos, at least for the time being.

But one expert feels that both drugs, which belong to a class of medications known as thiazolidinediones, should be avoided.

"Purely from a heart standpoint, none of these medicines have been shown to help and probably do increase the risk [of heart problems]," said Dr. Bryan Henry, a cardiologist and assistant professor of medicine at the University of Rochester Medical Center in New York. "I think glucophage or Metformin should always be the first-line drug to start treatment."

While not preventing heart attacks or strokes, Avandia and Actos have been shown to prevent some of the microvascular complications of diabetes, such as kidney trouble and neuropathy.

The new study, published Aug. 24 in the journal Circulation: Cardiovascular Quality and Outcomes, differed from many previous trials in several respects, which may account for the differences in findings.

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Copyright © 2010 HealthDay. All rights reserved.
Last updated 8/24/2010

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SOURCES: Debra Wertz, Pharm.D., outcomes research manager, HealthCore, Inc., Wilmington, Del.; Bryan Henry, M.D., assistant professor of medicine, University of Rochester Medical Center, New York; Kirk Garratt, M.D., clinical director of interventional cardiovascular research, Lenox Hill Hospital, New York City; Aug. 24, 2010, Circulation: Cardiovascular Quality and Outcomes


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