glitazones - diabetes

Drug Avandia

Statement by Sidney Wolfe, MD, Director of Health Research Group at Public Citizen

The New England Journal of Medicine study just released showing a 43 percent increase in heart attacks in people using Avandia should come as no surprise either to the Food and Drug Administration (FDA) or to Glaxo. In animal studies done prior to its approval, one of the most constant findings was damage to the heart, and within the first six years of approval there have been 689 cases of heart failure reported to the FDA in patients using the drug. In addition, there have been reports of anemia which, along with heart failure, increases the risk for a heart attack.

other side effects

• principal unwanted effects include weight gain (about 5%, or 3.5 kg over 6 months)
• water retention and leg oedema (in about 5%)
• dizziness, headache, fatigue, and hypoglycaemia (only when used in combination with a sulphonylurea) has also been reported with both drugs in combination therapy
• other reported effects with pioglitazone include visual disturbances, arthralgia, impotence, flatulence, proteinuria, haematuria and with rosiglitazone, gastrointestinal disturbances, rash, paraesthesia, dyspnoea, rash, alopecia and thrombocytopaenia
• since rosiglitazone and pioglitazone can cause fluid retention, which may exacerbate or precipitate heart failure, these drugs should be avoided in patients with any current, or history of heart failure - note that all patients taking either glitazone should be monitored for features of heart failure
• macular oedema - cases of new onset and worsening macular oedema have been reported in patients treated with rosiglitazone. It has been reported that "in some cases, macular oedema resolved or improved following discontinuation of therapy and in one case macular odema resolved after dose reduction "(2)
• cardiovascular risk - there has been evidence from a meta-analysis concerning the use of rosiglitazone and increased risk of myocardial infarction (3) - for more detail see linked item

Here is some debate about the heart attack issue

My thoughts - it's not that effective so why bother with it at all!!!