New Avandia Restriction

Started by Sparda29
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Here's my two big problems with this whole thing.

1) If Avandia is so damned bad, what about Actos? My guess is this entire problem is related to the class of the drugs, and Actos isn't terribly different from Avandia

2) Relating to this, one of the front runners for the study 'breaking' the news on Avandia was funded, or related somehow, I can't remember which, to Takeda.

Always found it funny how Avandia is the most evil drug on the market right now, but no one is asking about it's cousin Actos.
 
phathead said:
Here's my two big problems with this whole thing.

1) If Avandia is so damned bad, what about Actos? My guess is this entire problem is related to the class of the drugs, and Actos isn't terribly different from Avandia
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Perhaps you should look up some studies that compared the percentage change of LDL levels in patients taking rosiglitazone vs pioglitazone. This isn't recent. Or even when the big Nissen study came out in 2007. I'm talking 2003, 2004.
2) Relating to this, one of the front runners for the study 'breaking' the news on Avandia was funded, or related somehow, I can't remember which, to Takeda.
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It was more like there is a dude at the Cleveland Clinic that takes obvious biochemical changes and turns them into studies. More than anything else, it showed how little the average physician knows about what changes specific drugs cause in the human body. Doctor Obvious up there in Sixth City...lmao...

Always found it funny how Avandia is the most evil drug on the market right now, but no one is asking about it's cousin Actos.
Click to expand...

I always thought it was funny how looking at LDL levels and overall likelihood for hyperlidemia-induced disease isn't even a consideration in any prescribing guidelines.
 
phathead said:
Here's my two big problems with this whole thing.

1) If Avandia is so damned bad, what about Actos? My guess is this entire problem is related to the class of the drugs, and Actos isn't terribly different from Avandia

2) Relating to this, one of the front runners for the study 'breaking' the news on Avandia was funded, or related somehow, I can't remember which, to Takeda.

Always found it funny how Avandia is the most evil drug on the market right now, but no one is asking about it's cousin Actos.
Click to expand...

Neither of those are true. This isn't a class effect, and that was shown in the same manner by the same person (how informative meta-analyses are is another debate for another day) in a 2007 JAMA study. Also, in all honesty, funding for these studies is not a big issue. Meta-analyses, especially the kind that Dr. Nissen performed, are fairly easy to complete and utilize existing data that is, for the most part, readily available.

Now, like Mike said, pioglitazone has other interesting characteristics. It actually has some atherosclerotic benefit versus other antidiabetics (I thought it was the sulfonylureas, not rosiglitazone?), which rosiglitazone clearly doesn't have. But, it also causes fluid retention which may precipitate heart failure in patient's at risk. So it's a mixed bag.

Regardless, do your research. It's nice to think that ever seemingy idiosyncratic adverse event is a class effect, but that's not really true. Even looking at metformin, most of the data for lactic acidosis comes from phenformin.
 
rofecoxib
valdecoxib
gatifloxacin
cerivastatin
terfenadine

to name a few that show lack of class effect
 
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