Given that there may be unique, albeit limited, circumstances in which the thiazolidinediones work best, the drugs should continue to be available for use at the physician's discretion, Zonszein advocated.
"Avandia is already rarely prescribed," he said. "Let the free markets work following science not politics."
However, the numbers from IMS Health show that Avandia continued to be prescribed to 2.6 million Americans in 2009--no small number, though smaller than the blockbuster drug once saw.
What the FDA will actually do is anyone's guess. While some had strong opinions about what the agency should do, no one at the ADA meeting was willing to hazard what would actually happen.
Eckel reported having a pending preclinical research grant with GlaxoSmithKline for an unrelated drug.
Nissen reported having received research support from AstraZeneca, Atherogenics, Eli Lilly, Novartis, Pfizer, Resverlogix, Takeda, Daiichi-Sankyo, and Sanofi-Aventis through the Cleveland Clinic Center for Clinical Research within the last five years and having consulted for a number of pharmaceutical companies but with all fees paid directly to charity.
Nathan reported no conflicts of interest.
Zonszein reported being on an advisory board for Takeda, which makes pioglitazone, and on the speakers bureau for Takeda, Eli Lilly, Novo Nordisk, Merck and many other companies that make diabetes medications, although not GlaxoSmithKline.