FDA Panel: Avandia Should Remain on Market

"I will not use [Avandia] and I am aware of other physicians who have made that decision," said Dr. Neil Brooks, past president of the American Academy of Family Physicians.

"The information from the FDA is disturbing," he said. "I believe that most physicians will discontinue the use of Avandia. This is especially true since [Actos, another oral diabetes drug] is available and seems to have a better safety profile."

Actos, a drug made by Takeda Pharmaceuticals in the same class as Avandia but with a different chemical makeup, has benefited significantly from Avandia's decline. Actos held a share of roughly 12 percent of new prescriptions before the announcement of Avandia's association with heart attacks and now holds around 22 percent.

Data show that nearly 60 percent of all switches in diabetes medication were to Actos just two weeks after the announcement -- an increase of around 45 percentage points during that time.

Do Benefits Outweigh the Risks?

But while some physicians want Avandia off the market, others say that Avandia is not much different from many other drugs that have side effects. So as long as the benefits outweigh the risks, they say nothing should change.

"I am very worried about how people will interpret these findings," said Dr. Anne Peters, the director of the clinical diabetes programs at the University of Southern California's Keck School of Medicine. "All drugs have side effects. All drugs can kill you. But the diseases we are treating are far more dangerous.

"I think there is much more danger in patients who are well-treated being pulled off medication," she said.

And Gottlieb said focusing too much on the risks of certain useful drugs could turn out to be both expensive and counterproductive.

"I fear that the task of uncovering these kinds of latent risks -- which is the sort of risk Avandia is believed by some to harbor -- the kinds of risks that can only be unmasked with prolonged use of a drug, is going to be much, much harder and more expensive and cause the delay of a lot of potentially useful medicines," he said.

Company Fires Back

As Graham and other researchers made the case for the removal of Avandia from the market, GSK fired its own salvo of studies at the FDA expert panel asserting the drug's safety and benefits.

"We certainly believe that Avandia is an important treatment option for physicians," Mary Anne Rhyne, a spokesperson for GSK, told ABCNEWS.com Monday morning.

The centerpiece of GSK's defense is a company-funded study, the results of which were released after the May analysis. The study, which GSK said took into account data on more than 400,000 type 2 diabetes patients, provides safety evidence contrary to the findings published in NEJM.

The company-funded study "provides strong evidence that Avandia is not associated with the increased risk of heart attack suggested as part of a previously published meta-analysis," according to a statement by the company.

Rhyne said GSK would not respond specifically to Graham's call for the drug to be pulled off the market.

But why the discrepancy between the NEJM analysis and the studies presented by GSK? Rhyne said these contradictions can be explained by a difference in study design.

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