Thursday, July 05, 2007

Is Avandia Safe?

If you're a diabetic and on a medication called Avandia (Rosiglitazone) and you read the news you're probably pretty scared. A few weeks ago a study came out in the New England Journal of Medicine that concluded, via a meta-analysis of other studies, that taking Avandia increased the risk of severe cardiovascular disease or death from cardiovascular causes by 8%.

I read the meta-analysis and I'll be honest, my knowledge of medical statistics was insufficient to truly decide how scary this all was. I chose to start taking my patients off Avandia and putting them on other medications figuring that until the issue is more firmly established one way or the other, I'd err on the side of caution.

This week the New England Journal of Medicine invited a diabetologist, a cardiovascular epidemiologist, and a drug-safety expert to give their opinions on the study and their views are available on the New England Journal's website for free here (scroll down to the editorial content and click on the free full text links).

Their conclusions?

Same as mine (but with their knowledge of statistics and study design backing them up) - given that there is certainly uncertainty regarding Avandia's safety and that alternative drugs for diabetics are readily available, it would seem prudent to consider switching patients off Avandia.

If you're a patient taking Avandia I would not recommend stopping it on your own. Go and see your physician and discuss it with them. If you were to stop it on your own without an alternative your sugars may climb dramatically high which certainly carries with it far more established and dramatic risks than staying on the Avandia for the extra few days it may take you to set up your appointment with your doctor.