Will New Potential Benefit Breathe New Life into Avandia?

Vancouver, BCIn what will likely serve to only complicate the continuing debate over the safety and efficacy of Avandia, new research is suggesting that the class of diabetes drugs to which Avandia belongs may both prevent, and contain lung cancer. The findings were presented yesterday (November 2nd) at the annual meeting of the American College of Chest Physicians in Vancouver.

Preliminary data has shown that certain medications designed to control diabetes may have the added benefit of protecting against tobacco-induced lung cancer. This latest research appears to back that up.

However, the timing couldn't be worse given the ongoing debate over Avandia side effects. While the Type 2 Diabetes drug was pulled from the European market, the US Food and Drug Administration (FDA) moved to implement severe restrictions on its use in the US, but resisted the temptation to urge a complete removal from the market.

Avandia, manufactured by GlaxoSmithKline (Glaxo), has been under intense scrutiny for a few years over concern for Avandia heart attack. To that end, a previous report by Drs. David Graham and Kate Gelperin of the FDA concluded, "rosiglitazone (Avandia) should be removed from the market."

Their studies claimed that if every diabetic currently taking Avandia (as of February this year) was switched to rival Actos, approximately 500 heart attacks and 300 cases of heart failure would be averted.

Avandia isn't the only diabetes drug thought capable of helping out the lungs when it comes to cancer. Metformin, together with the class of drugs known as thiazolidinediones are thought to have a positive affect on lung cancer.

"Patients who did not develop lung cancer had a much higher chance of taking one of these medications than those who did develop lung cancer," said study author Dr. Peter Mazzone, in comments published November 2nd in Health Day News. "And those who did develop lung cancer were much less likely to have seen that cancer spread outside the chest and more likely to survive longer with one of these drugs."

Avandia is included in the thiazolidinediones class.

But so is Actos.

The latter, which is considered by some as a safer alternative to Avandia, has benefitted from the ongoing concern over the various Avandia risks—which can include Avandia liver failure and Avandia fracture—to the ultimate frustration of Glaxo, which continues to stand behind its drug.

Will this latest news about a new benefit of thiazolidinediones drive even more patients to Actos, and away from Avandia?

It should be noted that we are a long way from applying this study to humans, given that research results were derived from studies on mice. "There have been no direct studies using these medications in humans for the purpose of preventing or altering the course of lung cancer," Mazzone said. "We need to fully understand the mechanisms by which these medications might prevent or change the course of cancer. We need to develop large clinical trials using these medications and following people forward to see if they are protective, as retrospective studies have suggested."

There is also the issue of the safety profile associated with both Actos and Avandia. Both, according to Health Day News, have been shown to raise the chances of developing cardiovascular risk factors. However, of the two, there is a general feeling that those risk factors—including Avandia death—is greater with Avandia over Actos.

It remains to be seen if either drug will benefit from use in non-diabetics as a hedge against lung cancer, pending further study.