Diabetes drug taken by tens of thousands 'is linked to heart failure'

Published on Tuesday 18 August 2009 22:03

A DRUG to treat patients with Type 2 diabetes is linked to an increased risk of heart failure and its continued use may not be justified, a study said yesterday.

Research in the British Medical Journal found that rosiglitazone – also known as Avandia – was associated with a higher risk of heart failure and deaths among older patients compared to a similar drug.

The researchers concluded "continued use of rosiglitazone is difficult to advocate".

GlaxoSmithKline (GSK), makers of the drug, said other research had found no differences between the two drugs.

Tens of thousands of UK patients use rosiglitazone, which helps make the body more responsive to insulin in Type 2 diabetics.

But two years ago, research in the New England Journal of Medicine suggested it may raise the risk of heart attacks and cardiovascular deaths.

Last year, The Scotsman revealed Scottish doctors had concerns about the drug. NHS Greater Glasgow and Clyde ruled only diabetes specialists could initiate treatment, rather than GPs.

Rosiglitazone and another drug, pioglitazone, belong to a class of drugs called thiazolidinediones, used to treat Type 2 diabetes. They help to control blood sugar, but can cause weight gain, fluid retention and heart failure.

The latest study, by a team in Toronto, Canada, set out to compare the risk of heart attack, heart failure and death in patients treated with the drugs.

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

They followed any admissions to hospital caused by heart attack or heart failure and also the recorded deaths.

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

Researchers, led by Dr David Juurlink, estimated for every 93 patients treated with rosiglitazone rather than pioglitazone, one extra admission to hospital with heart problems or death would be expected each year.

"Our findings suggest clinically important differences in the cardiovascular safety profiles of rosiglitazone and pioglitazone in clinical practice," the researchers said.

They added: "Given the accumulating evidence of harm with rosiglitazone treatment and lack of a distinct clinical advantage over pioglitazone, questioning whether ongoing use of rosiglitazone is justified in any circumstance is reasonable."

A spokesman for GSK said: "The study by Juurlink et al is not reflective of evidence from two randomised controlled trials, where no differences in heart failure were seen between rosiglitazone and pioglitazone."

Dr Iain Frame, from Diabetes UK, said: "The claim that one drug is safer than the other remains inconclusive.

"Perhaps longer term follow-up studies would be useful."