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Avandia debate continues

GlaxoSmithKline’s diabetes Avandia, previously plagued by problems associated with heart attacks, is in the news again. Late last week, GSK announced results of a large-scale clinical trial claiming that in the long term Avandia did not increase cardiovascular risk “compared to other commonly used diabetes medicines”.

The news means that GSK will hope that sales get a boost, but also that doctors will prescribe the drug more. “We believe that Avandia remains an important diabetes medicine for the appropriate patients,” said Ellen Strahlman, GSK’s Chief Medical Officer.

But there is still resistance. In the same issue of the Lancet (summary here) where the results of the trial, called Record, were published, Ravi Retnakaran and Bernard Zinman from Mount Sinai Hopsital, Toronto, Canada, offer caution. “definitive conclusions about the relation between rosiglitazone and cardiovascular disease remain elusive,” they say, and look at not just Avandia, or rosiglitazone but also a drug in the same thiazolidinedione family, pioglitazone.

“We believe that the evidence regarding the risk–benefit ratio for thiazolidinediones needs a prudent approach to the use of these medications in the management of type 2 diabetes.”

The whole thing is rounded up nicely over at FiercePharma, including links to other coverage and explanation of some of the controversies that have plagued the drug’s history. The debate will rage for some time it seems.


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