Avandia's Heart Risk Higher Than Others in Its Class

A similar diabetes drug, Actos, doesn't seem to carry same dangers, study finds

By Steven Reinberg
HealthDay Reporter

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MONDAY, Nov. 24 (HealthDay News) -- The widely used diabetes drug Avandia -- already controversial because of cardiovascular side effects -- may be riskier than Actos, another drug in the same class, researchers reported Monday.

The risk of heart failure and death for older diabetics appears greater with Avandia (rosiglitazone) than with Actos (pioglitazone), both of which are part of a class of drugs called thiazolidinediones, Harvard University researchers said.

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Avandia and Actos are used to lower blood sugar in patients with type 2 diabetes. Recent studies suggested that the risk for heart failure, death and heart attack were increased with Avandia, touching off a controversy that resulted in new FDA-mandated label warnings about the drug.

"By contrast, Actos did not appear to increase the risk of cardiac events," said lead researcher Dr. Wolfgang C. Winkelmayer, an assistant professor of medicine at Harvard Medical School. "One could get the impression that Actos led to the reduction of heart attacks."

Indirectly, people inferred that it might be better to use Actos, because Avandia has cardiovascular risks associated with it, Winkelmayer said.

"We did find that patients using rosiglitazone actually had an increased risk of mortality from any cause. We did not find a difference in heart attacks and strokes," Winkelmayer said. But, he added, more patients taking Avandia were hospitalized for heart failure.

Winkelmayer noted differences in drugs in the same class are not unusual. For example, cholesterol-lowering statins (which include Crestor, Lipitor and Zocor) have different side effects, he said.

The new research, published in the Nov. 24 issue of the Archives of Internal Medicine, received funding from the American Heart Association, as well drug makers Amgen and GlaxoSmithKline, which makes Avandia.

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