Another wonder drug fails

First it was Vioxx and Celebrex, which really helped arthritis but unfortunately, due to their mode of action, also increased the risk of heart disease. Now, a major new drug used to treat type II diabetes, Avandia (rosiglitazone), may be in trouble. Preliminary studies (which must be confirmed with a larger sample size) indicate an over 40% greater risk of heart attacks for patients on Avandia than in control groups receiving other standards of care.

Avandia works by activating a receptor in the cell, PPAR-gamma, which then modifies the transcription of various genes having to do with lipid metabolism, and other things. It is useful in diabetes because it sensitizes cells to insulin, supposedly helping to reduce hyperglycemia and other side effects of insulin resistance. But, it appears that there is either a non-specific effect leading to increased heart attacks, or PPAR-gamma has some other role yet to be discovered. We’ll see–the results publicized in the news are just preliminary, but it proves the adage that my old clinical medicine instructor drilled into us: “The only drugs without side effects are new drugs.”


2 Responses to “Another wonder drug fails”

  1. 1 Argent May 22, 2007 at 9:48 am

    How long has Avandia been out and how popular is it in scripts?

  2. 2 Edmund C. May 22, 2007 at 9:58 am

    Been out several years–it was just starting to be widely prescribed in 2000 when I went on community practice rotations. It’s pretty popular AFAIK, but expensive so not used as much as it might be…

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