What is Digg?32 Comments
- lunasunshine, on 10/10/2007, -0/+7This is not new news. These drugs cause fluid retention and eventually can cause CHF in patients as the heart tires itself against all the extra vascular volume. I have been advising physicians of this for at least 5 years now. The real news with these drugs is the 43% increase in heart attack seen with avandia.
/pharmacist - Error601, on 10/10/2007, -1/+8Of course untreated diabetes increases the chance of death considerably more.
- MemeWarrior, on 10/10/2007, -2/+7Not everyone who has Diabetes is fat either you insensitive SOB!
- manuelhp42, on 10/10/2007, -1/+4Here's an ongoing discussion about this topic in TuDiabetes.com, a community of people touched by diabetes:
http://tudiabetes.com/forum/topic/show?id=583967%3ATopic%3A3343 - catalysis, on 10/10/2007, -0/+3It's good that we have researchers to do these types of studies and get conclusive info on the risks associated with these medications. Ultimately it is up to the doctor and patient to weigh the pros and cons of any treatment.
- lunasunshine, on 10/10/2007, -0/+2You are confusing heart disease with heart failure. Actos and Avandia cause heart FAILURE. only avandia so far, has been shown to increase the risk heart ATTACK
- kohlmannj, on 10/10/2007, -0/+2Here's a link to the original release from the Wake Forest University Baptist Medical Center, for those interested in the primary source:
http://www1.wfubmc.edu/news/NewsArticle.htm?Articleid=2129 - Malakin, on 10/10/2007, -0/+2A quick Google of Pioglitazone (Actos) reveals many studies linking it to heart failure.
http://scholar.google.com/scholar?hl=en&q=Pioglitazone+%22heart+failure%22&ie=UTF-8&oe=UTF-8&um=1&sa=N&tab=ws - pimpbot1979, on 10/10/2007, -2/+4For the record, there are significant studies showing a link between avandia and heart disease but the majority of well designed studies also show there is no such association with actos. I don't know where this article is getting its information regarding actos but it is still being used with relative confidence by my colleagues.
- dtreese, on 10/10/2007, -0/+2It's really a shame to see these drugs get such bad press, because they've done a lot of good for a lot of patients. Giving diabetes patients oral alternatives to insulin increases compliance and glucose control. As with many drugs, there is a potential for deleterious side effects. If a new diabetic is coming in for proper follow-up, though, any problems with heart failure should come up on physical exam.
As for the notion that this study was "conclusive," the article shows acknowledges that they did not study why people were developing heart failure. One very important mantra of research science is that correlation does not equal causation.
We have learned something very valuable from this study -- people who are on these drugs need to be monitored more carefully than we previously thought. What we have NOT learned is that these drugs cause heart failure. That was not proven by this study. It's a shame when drugs like this that are beneficial to so many get yanked from the market prematurely.
/medical student - SlamShut, on 10/10/2007, -0/+1Is there a better alternative to this drug, other than not taking a medication at all? My father takes Actos, and I'd like to have him stop taking it if there's a better alternative med. Can you suggest one that I can look into?
- SlamShut, on 10/10/2007, -0/+1He already takes Metformin and Glipizide. I should perhaps mention that he's 80 years old. He takes 8 different meds per day.
Thanks for the suggestions; I'm going to talk to his doctor tomorrow to see if he shares any concerns about Actos. - ccrook, on 10/10/2007, -0/+1Was your mother overweight before she started taking it?
What does the medication have to do with walking?
2 serious questions before you give anecdotal evidence about anything. - lunasunshine, on 10/10/2007, -0/+1no offense, but LOL.
I actually just finished my residency and presented the rosiglitazone dilemma to my P & T committee. I have read the exact editorial that you almost quote directly from. I have also read many other editorials about this. We decided to take avandia off of our formulary. Is the type 2 diabetes group really the ones that you want to possibly give an INCREASED risk of MI? honestly? There are so many other drugs out there for this condition. - Arkonnan, on 10/10/2007, -1/+2My mother was put on Avandia by her doctor. She lost 24 pounds in one month and had problems walking. That stuff ***** her up pretty bad. Suffice it to say, it's not for everyone.
- lunasunshine, on 10/10/2007, -0/+1Avandia causes fluid retention and weight gain.
- Arkonnan, on 10/10/2007, -0/+1She is overweight, but not by more than 30 pounds or so. As for her trouble walking, the effect the medication had made her feel week in the legs. She said she could barely walk after a while. Take from that what you will, but as soon as her doctor got her off Avandia she showed an immediate improvement and has been fine ever since.
- Senseless, on 10/10/2007, -1/+2I think it's important to note that pharmaceutical firms have a history of not publishing internal medical trial results that are not favorable. Yes, they will do trial after trial, and wait until they get (or can manufacture) favorable results before publishing. The NE Journal of Medicine (and some other publications) had been talking about refusing to publish trials at all unless the firms agree to make public the results of every single trial they run.
BTW, I'm a type II diabetic and had been put on Actos for the last 2+ years. During my last visit (at probably the premiere diabetes clinic in the country), my doctor suddenly decided to take me off it. I asked if it was because of the avandia issues, and he claimed it was not, but was not able to actually give me a reason for discontinuing the drug. Very unusual as I was trying to add or change medicines to improve my HBA1C, and just removing a supposedly helpful medicine from the regimen without a reason was strange.
Wonder if this will end up being a diabetic Vioxx type class action suit.. - lunasunshine, on 10/10/2007, -0/+1actos (pioglitazone) has a study that shows positive cardiac results. I question this, but at best it most likely has a heart attack neutral effect (doesn't do anything good or bad). Although, if he is at risk for CHF or has CHF, try a new class IMO. All of the drugs in this class can cause and exacerbate CHF. metformin is great, but not good if you have kidney impairment. Byetta has positive results, but is an injection and expensive (but it does cause weight loss). Januvia seems somehwat benign, but it doesn't do that much (decreases A1C by only about 0.5 - 1.0 %). How bout glipizide or glyburide?
- gorditas, on 10/10/2007, -2/+2@lunashunshine
The 43% increase in heart attack seen with Avandia which was taken from a NEJM article published in June I believe is a bit misleading. The data published in the NEJM article looked at 15,565 patients who had taken Avandia, and 12,282 patients who took other diabetes medications (single meds, or various combinations).
In the Avandia treatment group, there were 86 reported myocardial infarctions compared with 72 in the control group. Although the odds ratio of having a myocardial infarction after being treated with Avandia was increased by 43% vs. control (placebo or any combination of all other diabetes medications) the number of patients having an MI was quite minuscule given the number of patients being evaluated in the study.
The difference in number of people having an MI between the Avandia and control groups was 14 out of almost 28,000 patients. In my mind, the number of patients helped by medications such as Avandia may be greater than the number hurt, and articles such as the NEJM one can have statistics manipulated such that the outcomes seem very alarming.
As a "pharmacist" you should be careful being an alarmist yourself.
/pharmacy student - yodaj007, on 10/10/2007, -4/+4Yes, your meaning was offensive. Dugg down.
- edvas, on 10/10/2007, -1/+1You sound like you're full of self-hate. Kudos to you for busting your ass, but there's no need to be a jerk.
- SPECOPS, on 10/10/2007, -0/+0Don't sweat the small stuff, you'll live longer.
- ccrook, on 10/10/2007, -2/+2A couple comments down a guys mom lost weight supposedly because she was on it. You lost wait once you got off it.
Conclusions that can be drawn from both stories? 0. - netburnr, on 10/10/2007, -1/+1My girlfriend's brother is about as healthy looking as they come, 5'10, about 200 lbs of muscle, he works out every day, but he has been battling Diabetes since his childhood.
Dont be a hateful dick. - NiGHTSChao, on 10/10/2007, -4/+4Diabeetus?
- dtreese, on 10/10/2007, -3/+1I get your meaning, and I pity you. Dugg down.
- MeMongo, on 10/10/2007, -6/+2Maybe you should consider losing weight then. It isn't easy, I have to bust my ass to maintain a healthy weight (probably from not having a very active childhood and being in my late 30s doesn't help much either), but I set aside an hour a day, every day, for running. If I didn't, I'd easily be over 200 pounds now.
- RanIntoTheDevil, on 10/10/2007, -9/+1Yeah, but marijuana "causes" schizophrenia. At least with these only cause heart failure and have medicinal value unlike marijuana...Oh wait...
Totally hijacked! - MeMongo, on 10/10/2007, -12/+2This should unnerve some of the fatties here in the U.S. Of course not everyone with diabetes is fat and vice-versa, but you get my meaning.
Check out the new & improved 
© Digg Inc. 2009
— Content created and posted by Digg users is