Avandia, Actos Double the Risk of Fractures Among
Diabetes Patients
These two drugs account for 21% of oral diabetes
medications in U.S.
April 29, 2008 - Diabetics taking rosiglitazone (Avandia)
or pioglitazone (Actos) approximately double or triple their odds of hip
and other non-spine fractures, according to a report in the April 28
issue of Archives of Internal Medicine, one of the JAMA/Archives
journals. Diabetes is a leading chronic disease among senior citizens
that are often fighting the dangers of bone fractures from osteoporosis.
And, it was a no win day for these elderly, as the journal also reported
a drug for this ailment may cause atrial fibrillation (see sidebar).
Thiazolidinediones medications (including rosiglitazone
(Avandia)
produced a significantly increased risk of heart attack, congestive
heart failure and death
The odds for fracture were increased among patients
who took the diabetes drugs for approximately 12 to 18 months and the
risk was highest for those with two or more years of therapy.
The insulin-sensitizing thiazolidinediones are a
relatively new and effective class of oral antidiabetic agents that have
gained wide use in clinical conditions characterized by insulin
resistance, the authors write as background information in the article.
Two drugs in this widely used class of diabetes
medications, pioglitazone and rosiglitazone, account for 21 percent of
oral diabetes medications prescribed in the United States and 5 percent
of those in Europe. Recent studies have suggested that these therapies
may have unfavorable effects on bone, resulting in slower bone formation
and faster bone loss.
Christian Meier, M.D., of University Hospital
Basel, Basel, Switzerland, and colleagues studied 1,020 patients with
diabetes who had fractures diagnosed at British general practitioners
offices between 1994 and 2005. For each of those patients, up to four
control patients with diabetes who were the same age and sex and had the
same physician but did not have fractures were selected, for a total of
3,728 matched controls.
This analysis provides further evidence of a
possible association between long-term use of thiazolidinediones and
fractures, particularly of the hip and wrist, in patients with diabetes
mellitus, the authors conclude.
No such effect was seen for other antidiabetic
drugs in this study population. These findings, although they are
consistent with recently reported data from a randomized trial, are
based on relatively few thiazolidinedione-exposed patients and need to
be confirmed by additional observational studies and by controlled
clinical trials.
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