Avandia heart risks seen at the population level

Avandia heart risks seen at the population level
NEW YORK (Reuters Health) - The findings of clinical trialshave linked the use of thiazolidinediones, a class of diabetesdrugs, with congestive heart failure and possibly heartattacks. Now, new research indicates that these associations,at least with Avandia, also apply to individuals in thecommunity, and not just clinical trials.
Dr. Lorraine L. Lipscombe, from the Institute for ClinicalEvaluative Sciences in Toronto, and colleagues analyzed datafor 159,026 older adults who were treated with at least oneoral diabetes drug between 2002 and 2005 and were entered in anOntario healthcare database. The subjects were followed throughMarch 2006.
During an average follow-up period of 3.8 years, 7.9percent of the patients were hospitalized for congestive heartfailure, 7.9 percent were hospitalized for a heart attack, and19 percent died, according to the researchers' report inJournal of the American Medical Association.
Current thiazolidinediones use increased the risks of heartfailure, heart attack and death by 60 percent, 40 percent, and29 percent, respectively, compared with the use of other typesof oral diabetes drugs.
Further analysis revealed that the risks were largelyconfined to patients who were using Avandia, known genericallyas rosiglitazone.
"These findings provide evidence from a real-world settingand support data from clinical trials that the harms ofthiazolidinediones may outweigh their benefits, even inpatients without obvious...cardiovascular disease," the authorswrite.
More studies are needed to better define the risk-benefitratio and the trade-offs associated with thiazolidinedionetherapy and to explore if the treatment risks are confinedspecifically to rosiglitazone.
SOURCE: Journal of the American Medical Association,December 12, 2007.