Thursday, June 12, 2008

Avandia vindicated?

A case-control analysis as well as a time-dependent covariate analysis of a study presented at ADA showed no excess cardiovascular risk associated with Avandia. Dr. Mintz gave us a time line and put all the evidence together on the Avandia controversy:

Since Dr. Nissen's meta-analysis showing risk with Avandia that is fraught with controversy, we have had multiple large, prospective, randomized clinical trials that show the opposite result. Between RECORD, ADOPT, DREAM, ACCORD and VADT;
there have been over 26,000 patients studied for over 3.5 years, of which more than 15,000 patients took Avandia and showed absolutely no difference in heart attacks or myocardial ischemia.

Maybe we were misled by Nissen’s meta-analysis. What’s even more unfortunate is the way the results were hyped and alternative explanations for the findings summarily rejected.

Via Kevin M.D.


Martin said...

However, it DOES cause heart failure - and that's bad enough.

Anonymous said...

I wouldn't say it CAUSES heart failure..maybe pt's with sub-clinical diastolic dsyfunction get volume overloaded especially when TZD is combined with insulin/or SU. Wasn't seen in the 5 year study vs Metformin or SU. The rates were exactly the same as metformin..(I beleive these were low risk patients). I guess we can put everyone on INSULIN. There are no risks to that.