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Link to Higher Rates of Heart Failure Found in Diabetes Drug - Tuesday, August 25, 2009

A drug used to treat type 2 diabetes, called rosiglitazone, has been linked to an increased risk of heart failure and death in older patients. The authors of the study, researchers in Canada, compared rosiglitazone to another drug, pioglitazone. Their findings were published in the British Medical Journal.

Both drugs belong to a class of drugs called thiazolidinediones and are commonly used for treatment of type 2 diabetes. They control blood sugar levels, but have similar side effects. Side effects of both drugs include fluid retention, weight gain, and heart failure.

Because it is unclear if cardiac safety is different in the two drugs, researchers looked at the risk of heart failure, heart attack, and death between rosiglitazone and pioglitazone. Using records, they identified 40,000 patients age 66 and older, who started treatment of the drugs between April 2002 and March 2008. Data was collected on hospital admission for heart attack or heart failure over these six years and deaths were identified through a national database.

Researchers found that those treated with pioglitazone had a significant decrease in the threat of heart failure death compared to those treated with rosiglitazone, but there was not a significant difference in risk of heart attack between the two drugs. They estimated that for every 93 patients treated with rosiglitazone rather than pioglitazone, there would be an additional "cardiovascular event or death" every year.

The authors of the study conclude that there are significant differences in cardiovascular safety between the two drugs, and believe that given the evidence of harm rosiglitazone causes and the lack of support that it is any better than pioglitazone, questions surrounding the drug's continued use are justified. However, they believe that more data is necessary before a drug recall is initiated.

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