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Oral Diabetes Drugs May Make Heart Failure Worse

By September 1, 2008

What Your Doctor Is Reading
What your doctor is reading is a regular feature that reviews current information about medications from medical journals often read by physicians.

According to researchers at Wake Forest University, a class of oral drugs (the thiazolidinediones), which includes Avandia (rosiglitazone) and Actos (pioglitazone) may make heart failure worse in people with type 2 diabetes.

The researchers had written several scientific articles in 2007 reporting that these drugs doubled the risk of congestive heart failure, and one of the medications, Avandia, was associated with increased heart attacks.

In a hard-hitting editorial published in the September edition of the medical journal Heart, the researchers recommend that regulators should limit the use of this class of diabetes medications. They also question the rationale for leaving Avandia on the market.

In an interview, one of the researchers noted that, "Safer, cheaper and more effective treatment alternatives are available that do not carry these negative cardiovascular risks in patients with diabetes.

Last year, the U.S. Food and Drug Administration (FDA) required the makers of both Actos and Avandia to place a black box warning the FDAs strongest warning on their labels indicating the increased risk of heart disease.

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September 2, 2008 at 10:40 am
(1) George Mandler says:

The Avandia scare is an unforgivable error in statistics. The original data were (approcimately) that the cardiac risk for Avandia was 2.5 of the relevant group, while the control group’s risk was 1.5%. The increase in risk reported was the RELATIVE increase of 1% as a percent of the 1.5% base, BUT the ABSOLUTE increase in risk is 1%!! Consider if the data were 25 and 15%, the relative increase would be the same but the absolute risk would be 10 times greater. The error is know as the base rate error. I have no connection with any drug company.

September 3, 2008 at 10:21 am
(2) Mike Bihari says:

George: Interesting comments about the statistics in the origianl article. Have you looked at some of the articles that followed, including an article in JAMA that pointed to an increased heart attack risk in people with diabetes who take Avandia? I’m not a statistician, but I do have type 2 diabetes and I am concerned about the evidence.

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