Coronary heart disease (CHD), also called coronary artery disease (CAD) and atherosclerotic heart disease, is the end result of the accumulation of atheromatous plaques within the ...
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Avandia and Risk of Heart Disease
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I posted this in the Diabetes community but will also add it here:
Yesterday in the New England Journal of Medicine a meta-analysis (study looking at combined results of many smaller studies) was published that showed Avandia could increase risk of death from MI Here are the details of the study with some translation on my part (abstract available on www.nejm.org) TITLE: Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes AUTHORS: Steven E. Nissen, M.D., and Kathy Wolski, M.P.H. 1) The authors conducted searches of the published literature, the Web site of the Food and Drug Administration, and a clinical-trials registry maintained by the drug manufacturer of Avandia (GlaxoSmithKline). 2) Of 116 potentially relevant studies, 42 trials met the inclusion criteria. The authors of this study tabulated all occurrences of myocardial infarction and death from cardiovascular causes. 3) RESULTS: In the 42 trials, the mean age of the subjects was approximately 56 years, and the mean baseline Hgb AIC was 8.2%. 4) In the AVANDIA group (as compared with the control group which was either placebo OR another diabetes medication) the odds ratio for myocardial infarction was 1.43 (odds ratio of 1 means equal risk in both groups) and the odds ratio for death from cardiovascular causes was 1.64 (again 1.0 being no additional risk) 5) CONCLUSIONS: AVANDIA (Rosiglitazone) was associated with a significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes that had borderline significance. 6) The authors conclusion was that despite the fact that this was a small number of studies patients and providers should consider the potential for serious adverse cardiovascular effects of treatment with AVANDIA for type 2 diabetes. 7) IMPORTANTLY: the other drug in this class (ACTOS) have been shown to DECREASE risk of heart disease in good randomized trials. I will be discussing this with my patients...and with so many other options for oral medications...it may be worth a change until we know more Thoughts? Dr O. Posted on 05/22/07, 04:05 pm |
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