Better or Worse? Avandia vs Actos Battle
August 31st, 2009. By janem
The Avandia/Actos battle has been making headlines since August 19 (BMJ.com) when a Canadian researcher suggested the oral diabetes treatment Actos is safer than Avandia. (Coincidentally, Takeda Canada announced a few days later that it reacquired the Canadian marketing rights for its Actos from Eli Lilly’s Canadian company. The drugmaker licensed the rights to Lilly under a worldwide agreement in 1999—financial arrangements were not disclosed.)
The similarities: Both Avandia and Actos belong to a class of drugs called thiazolidinediones, which are used widely to lower blood sugar in people with type 2 diabetes. In addition to an increased risk for heart failure, both drugs can also cause side effects that include weight gain and fluid retention. Both medications carry a U.S. Food and Drug Administration warning and both meds run the same risk of heart attack.
The discrepancies: Researchers found that patients taking Avandia were at greater risk of heart failure and death than those taking Actos. BUT Corinne de Vries, a professor of pharmacoepidemiology in the department of pharmacy and pharmacology at the University of Bath, England, and co-author of an accompanying journal editorial, pointed out that “People taking Avandia were sicker than those taking Actos, so these patients were more likely to develop heart failure.”
Back to the similarities: De Vries added that people who have a preexisting heart condition should not be started on either of these drugs. So is Actos the lesser of two evils? And why isn’t the drug glyburide more of a contender? Maybe it hasn’t been as aggressively marketed as Takeda’s Actos; after all it must have cost Takeda big bucks to buy back its moneymaker from Lilly. Oops, got sidetracked there…In a 24-week post marketing study, overnight hospitalization for congestive heart failure was reported in 9.9% of patients on Actos compared to 4.7% of patients on glyburide. Hmmm.
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