'Doctor, Should I Keep Taking Avandia?'
Physicians report different approaches when it comes to advising patients.
June 7, 2007 — -- "Should I switch from Avandia — or should I buy a home defibrillator?"
Dr. Marcia Zucker, a primary care physician at Massachusetts General Hospital, recently faced this very question from an 81-year-old diabetic patient on Avandia.
Similar accounts from other primary care physicians suggest that Zucker may not be alone in fielding questions from patients about the safety of the popular diabetes drug.
Recent studies of Avandia and its potential to cause heart attacks have created a commotion in the news, in doctors' offices, between scientists, and even in Congress.
And while one study in the New England Journal of Medicine on May 16 suggested that Avandia might increase heart attacks by 43 percent, the same journal on Tuesday released interim results from another study suggesting that Avandia may not be all that dangerous.
Many patients don't know what to do with this barrage of information about the drug's questionable safety. And what are their doctors telling them?
"Patients have asked questions about Avandia," said Dr. Patrick Cogley, a primary care doctor in Iowa. "I have told them to continue taking their Avandia."
Cogley added, though, that he has not given out any new prescriptions for Avandia, and a committee in his practice is further investigating the drug's safety.
Dr. Stanley Mirsky has taken an opposite approach. An endocrinologist at New York City's Lenox Hill Hospital, he said, "In my practice, I have stopped Avandia."
Mirsky said he is substituting other diabetes medications for Avandia.
Dr. Anthony McCall, professor of diabetes at the University of Virginia, said he takes a collaborative approach to the Avandia question, given all the controversial results.
"I hope patients will talk with their physicians," he said. "I would tell them I am unsatisfied with the inconclusiveness of the analyses available to date."
McCall wants patients to better understand the information themselves so that they can help make the decision based on their preferences.
