E-DRUG: Diabetes drug Actos (pioglitazone) increases fractures for men and women
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Our group (UBC Therapeutics Initiative, Canada) has a paper being
published today in Archives of Internal Medicine, which may be of
interest to E-Drug-ers. See details below.
Best regards,
Ciprian Jauca
Program Coordinator
Therapeutics Initiative
University of British Columbia
jauca@ti.ubc.ca
+1-604-822-0700
www.ti.ubc.ca
DIABETES DRUG ACTOS INCREASES FRACTURES FOR MEN AND WOMEN
The diabetes drug Actos increases bone fractures for men and women,
suggests a study published today in the American medical journal
Archives of Internal Medicine (http://archinte.ama-assn.org/).
We looked at the risk of fractures for patients with type-2 diabetes
taking either pioglitazone (Actos) or rosiglitazone (Avandia) to
control their blood sugar levels, as compared to patients taking a
sulfonylurea, an older class of drugs used for the same purpose.
“Actos was associated with a 50% increase in fracture risk, compared
to taking a sulfonylurea,” explains lead author Colin Dormuth. “We
also looked at the data for men and women separately. We were
surprised to find an increase in bone fractures for both men and women
treated with Actos.”
Manufacturers have previously issued Health Canada endorsed advisories
to health professionals to warn of the increased incidence of
fractures in women treated with Actos or Avandia. No similar warnings
have been issued relating to men. In this study the risk of fracture
among patients treated with Actos appeared to be higher for women but
apply to men as well.
“This study provides further evidence that treatment with glitazones
is associated with fractures in women,” said Dormuth. “It also
suggests Actos may increase fractures in men. This is important to
know because fractures put patients at risk of other health problems.”
Results from the study also indicate that Actos may possibly be more
strongly associated with fractures than Avandia, but this is not a
definitive result and should be seen as a basis for further research.
As a part of the study, we looked separately at the impact of Actos
and Avandia on fracture risk. Women, but not men, treated with Avandia
showed an increase in fractures. In contrast, results indicated that
both men and women treated with Actos showed an increase in fractures.
Glitazones have become increasingly controversial due to their
associated risk of adverse events. Both Actos and Avandia are
contraindicated for patients with heart failure, and a high-profile
meta-analysis linking Avandia to elevated risk of heart attack gave
rise to widespread concern about the safety of the drug.
Contact: Richard Morrow, health research analyst
Therapeutics Initiative, University of British Columbia
tel: 250-590-5955
email: richard.morrow@ti.ubc.ca