Expert questions diabetes drug study

Professor Corinne de Vries from the University of Bath's Department of Pharmacy & Pharmacology has urged diabetes patients not to stop taking their medication without consulting their doctor following research suggesting a link between the drug rosiglitazone and an increased risk of heart failure.

Research published today in the British Medical Journal (BMJ) suggests that rosiglitazone (Avandia), a drug used to treat type 2 diabetes, is associated with an increased risk of heart failure and death among older patients compared to a similar drug, pioglitazone.

However, Professor de Vries, Professor of Pharmacoepidemiology, has written in an accompanying editorial that the data in the study do not fully support the claim that pioglitazone should be favoured over rosiglitazone.

De Vries said that patients taking rosiglitazone were sicker than those taking pioglitazone, so these patients were more likely to develop heart failure.

She said: "The data presented by the Canadian study do not support the suggestion that you should favor one drug over the other.

"There is no reason to believe yet that there is a difference."

Rosiglitazone and pioglitazone belong to a class of drugs called thiazolidinediones and are widely used for the treatment of type 2 diabetes. They help to control blood sugar levels, but both drugs can also cause side effects including weight gain, fluid retention and heart failure.

In the study published in the BMJ, researchers in Canada compared the risk of heart attack, heart failure and death in patients treated with rosiglitazone and pioglitazone.

Using prescription records, they identified nearly 40,000 patients aged 66 years and older who started treatment with either rosiglitazone or pioglitazone between April 2002 and March 2008.

Data on hospital admission for either a heart attack or heart failure during the six-year study period were recorded and deaths were identified from a national database.

Detailed analysis showed that patients treated with pioglitazone had a significantly lower risk of heart failure and death compared to patients treated with rosiglitazone, but there was no significant difference in the risk of heart attack.

The study estimated that, for every 93 patients treated with rosiglitazone rather than pioglitazone, one additional cardiovascular event or death would be predicted to occur annually.

But whilst the study reinforces the message that thiazolidinediones should be avoided in heart failure patients, Professor De Vries cautioned that further research was needed to determine a full risk-benefit profile for the medicine.

She said: "Nobody should stop taking their medication without consulting their doctor."

People who have concerns regarding their diabetes treatment are urged to consult their GP and not to discontinue taking their medication.

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