Diabetics On Avandia Should Be Cautioned About Heart Failure

Kathleen Blanchard's picture
Avandia Risk for Diabetes Patients
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Avandia is a popular drug for diabetes treatment. One of the risks associated with both Avandia and Actos (thiazolidinediones), is heart failure. According to a study published November 24 2008 in the Archives of Internal Medicine, diabetics on Avandia (rosiglitazone) have an increased risk of heart failure and death than patients who take Actos, though they are both in the same class of drugs.

Actos and Avandia were developed to provide patients with better control of blood sugar levels, helping to delay the need to take insulin. The medications, available since 1999, carry a precautionary warning that they should not be used in patients with existing heart failure, known as a black box warning.

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The newly published analysis performed by Wolfgang C. Winkelmayer, M.D., Sc.D., and colleagues at Brigham and Women's Hospital and Harvard Medical School, Boston, questions whether either drug is safe. The researchers reviewed medical claims filed by 28,361 patients over age 65 that started taking either Avandia or Actos between 2000 and 2005 – 49.7 percent of the patients took Avandia, the rest Actos. The group then compared death rates between the two. In all, 1,869 patients died. Those taking Avandia had a 15 percent higher rate of deaths, and heart failure risk rose 13% in comparison to the patients taking Actos.

Heart failure is one of the most common reasons for hospitalization in the elderly. Symptoms include shortness of breath, swelling in the abdomen, legs and ankles. Medications can provide relief, but heart failure destroys quality of life, and can be difficult to manage. Diabetics on Avandia or Actos should speak with their physician about warning signs.

The authors write, "This study confirms the safety concerns that have been raised for rosiglitazone [Avandia] compared with pioglitazone [Actos], which, in turn, also cannot be considered a very safe drug given its well-documented effect on the risk of congestive heart failure." Diabetics, especially those who are elderly, should be cautioned about the risks of heart failure when taking Avandia.

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