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News Articles >> Saying 'No' to Avandia: Doctors are Taki..
Saying 'No' to Avandia: Doctors are Taking no Chances
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| August 8, 2007. By Gordon Gibb |
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Eustis, FL: While Avandia may still be viable for some patients in spite of possible increased risks for heart attack, stroke and kidney failure, most doctors are advocating a switch away from Avandia to an alternative drug therapy for their diabetic patients.
While possible risk factors for the antidiabetic drug - made by GlaxoSmithKline - have been known for some time, Avandia has been at the forefront of public consciousness since May 21st, when a sensational report in the New England Journal of Medicine (NEJM) by noted Cleveland cardiologist Dr. Steven Nissen, pointed to data that revealed, "an increased risk for heart attack in 43 per cent of patients using Avandia," against those who were not.
A congressional hearing early in the summer, followed by a federal drug review panel on July 30th, has only added fuel to the fire - and doctors have reported that their phones have been ringing off the hook ever since.
And with good reason. While the U.S. Food and Drug Administration (FDA) wrestles with their continuing investigation into Avandia and the possible language for a black box warning, patients have been advised to contact their doctor and address whether or not sticking with Avandia would be the right thing to do.
For some, it might - depending upon the individual. As with any medication, the benefits must outweigh the risks, and even with Avandia's deepening well of concern over adverse affects, for some patients a switch to an alternative drug could have devastating results.
To most however, an alternative drug might prove safer - and less expensive - than continuing with Avandia.
Dr. Flloyd Dillard maintains a busy practise in Eustis, Florida and has been busy over the last several days answering a constantly ringing phone, as concerned diabetic patients weigh in about their Avandia meds.
"I'm getting a lot of calls because of it," Dr. Dillard told a TV reporter from WESH 2 News. "And in actual fact what we do, if we have a patient who calls or comes in for their lab work, we generally scan the chart to see if they are on Avandia and offer to take them off the Avandia. If we have a patient who calls about it we offer to take them off of the Avandia and offer to switch them to another medication that does not have the side affects associated with it," Dillard said.
Additionally, there are drug therapies that contain the active Avandia ingredient rosiglitazone, and Dr. Dillard is taking his patients off of that as well. Alternatives to rosiglitazone can be less expensive than Avandia, with effectiveness approaching Avandia for treatment of diabetes without the allegedly grave side effects. Actos, manufactured by Takeda of Japan, is a competitor to Avandia and will likely be required to carry a black box warning as well. And while the jury is still out as too how much safer Actos is over Avandia, is has been suggested by the FDA's own experts that Actos has a higher level of safety, in that it can be prescribed to a patient already involved with insulin therapy. There may be no such safe option for Avandia.
Dr. Dillard of Florida says that at one time, 3-5 per cent of his patients were on Avandia. Today that percentage has dwindled to around two per cent, and as patients keep calling - where warranted - Dr. Dillard plans to switch them from Avandia to some other appropriate drug therapy.
Even with the federal drug review panel voting to keep Avandia on pharmacy shelves due to a lack of clear data, if not for a lack of a convincing argument, Dr. Dillard isn't taking any chances with his patients.
He advises that patients who are currently taking Avandia contact their doctor immediately, to decide the next step.
Diabetes affects a large number of Americans of all age groups. Combined, more than 18 million Americans suffer from diabetes, with the most common being Type 2. Some studies have shown that myocardial infarction can happen within 23 days of starting Avandia, and that one in five Avandia patients may experience heart problems. Cardiovascular difficulty is not restricted to the elderly, either. One study revealed that a quarter of those suffering a heart attack allegedly brought on by Avandia were less than 60 years of age.
Avandia has also allegedly been linked to stroke, kidney failure and bone fractures.
Do not discontinue your medication
unless specifically directed to do so by your doctor.
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