The continuing controversy surrounding the cardiovascular risk of GlaxoSmithKline’s diabetes drug Avandia has led to sharp declines in its use and a surge in sales of the competing drug, Actos. Although the drugs are similar and both had FDA warnings in 2007, Takeda’s Actos has been perceived to be safer for the treatment of type 2 diabetes.
Avandia (Rosiglitazone) and Actos (pioglitazone) belong to the same class of drugs, called TZDs or thiazolidinediones. They help the body use insulin more effectively by boosting the body’s sensitivity to the hormone and thus help control blood sugar.
The new study evaluated more than 36,000 diabetes patients. Of the 28,938 patients who were propensity-score matched, a methodology used to provide an estimation of treatment-effects that is as unbiased as possible, 602 patients taking rosiglitazone and 599 taking pioglitazone over a 33-month period suffered either a heart attack, heart failure, both, or died. This translates to about 4 percent of all patients taking either medication. The individual specific adverse events were also not significantly different between the two groups, and were:
- Heart attack – 96 patients on Avandia and 121 patients on Actos
- Heart failure – 265 patients taking Avandia and 243 taking Actos
- Heart attack and heart failure – 24 patients on Avandia and 18 on Actos
- Death – 217 patients taking Avandia and 217 taking Actos
This study has results different from earlier ones that found a greater risk of heart attack among Avandia users compared to patients on other treatments or placebo. In 2007, the Food and Drug Administration decided that the benefits of Avandia outweighed the risks, and it remained on the market although its use decreased significantly. In July 2010, an FDA advisory committee again reviewed numerous studies and recommended that Avandia remain on the market, although with additional warnings or restriction.
For the full report American Heart Association.