Saturday, September 15, 2007

Re: Study Links Diabetes Drug To Heart Failure, Sept. 12.

Since the publication of an article by Dr. Steve Nissen in the New England Journal of Medicine in May, 2007, suggesting that people taking Avandia (Rosiglitazone) may have a relative risk increase for heart attack, the popular press has been full of sensational but frequently inaccurate reporting, which may pose a risk to people taking these drugs.

This article discusses heart failure, which is just one of the items in the Journal article. Unfortunately, your article fails to note that the same report shows a 10% reduction in deaths due to heart attack in people treated with Avandia. The Post article does discuss the 43% relative risk increase for heart attack stated in a separate paper published in May and you also mention increased risk of death from a heart attack, but you fail to tell us that the increased risk of death did not reach statistical significance and is therefore an unreliable finding and contradicts the more recent article which shows no increase in cardiovascular death.

The reason that the controversy lingers on is the lack of clear evidence of increased risk. A large study to look specifically at cardiovascular risks failed to show the potential for harm.

Every medical treatment involves weighing the risks against the benefits. Avandia and the class of medications to which it belongs have been a real breakthrough in the treatment of diabetes. Avandia has shown in multiple studies that it lowers blood-glucose levels significantly and for a longer period of time than any other treatments. Additionally it is the most effective treatment we have for prevention of diabetes and that it is the only approved drug that we have that slows the deterioration of the pancreas.

In conclusion, it would be prudent for patients to discuss Avandia with their doctor before unduly discontinuing it.

Dr. J. Robin Conway, Canadian Centre For Research On Diabetes, Smiths Falls, Ont