Drug for diabetes works, but it has serious side effects

Source | The Los Angeles Times

By Thomas H. Maugh II

December 5, 2006

The first major head-to-head study comparing the newer diabetes drug Avandia with older medicines metformin and glyburide shows that Avandia provides better glucose control than metformin but carries more serious side effects and a higher cost, researchers said Monday.

For newly diagnosed type 2 diabetics, “metformin is still the first drug of choice,” said Dr. Steven Kahn of the University of Washington and the Puget Sound Veterans Affairs Health Care System, who led the study.

Both Avandia and metformin — a generic also sold under the brand names Glucophage and Fortamet — performed substantially better than glyburide, however.

“People who use glyburide will have to think about changing drugs,” Kahn said.

The results of the study were reported Monday at the 19th World Diabetes Congress in Cape Town, South Africa, and will be published Thursday in the New England Journal of Medicine.

The study was funded by Avandia’s manufacturer, GlaxoSmithKline. Kahn reported receiving consulting fees, grants and lecture fees from the company.

The study enrolled 4,360 newly diagnosed diabetics who never had received drug therapy for the disorder. The patients were divided randomly into three groups, each of which received one of the drugs. The main goal of the study was to determine the time until the therapy stopped working and the patients required the addition of a second drug for glucose control.

At the end of five years, 15 percent of patients receiving Avandia needed a second drug, compared with 21 percent of those receiving metformin and 32 percent of those receiving glyburide.

But 62 patients taking Avandia developed a heart problem, compared with 58 taking metformin and 41 taking glyburide.