Patients who choose to continue to use the drug must review statements describing the cardiovascular safety concerns associated with Avandia and acknowledge they understand the risks. Their doctors must also attest to and document their patients’ eligibility.

The new rule applies to all drugs containing rosiglitazone, including Avandia , Avandamet (rosiglitazone and metformin) and Avandaryl (rosiglitazone and glimeperide).  GlaxoSmithKline, the maker of Avandia, says it will inform pharmacists and doctors about the new program over the next two months. Patients are advised to discuss their diabetes treatment options with their doctors.

More than 23 million Americans are believed to have type 2 diabetes, and nearly 500,000 Americans filled prescriptions for rosiglitazone in the first 10 months of 2010. At that point, prescriptions dropped considerably as news of the restrictions due to health risk were announced.

SOURCE: Avandia Recall › FDA to remove Avandia from retail pharmacies

Researchers announced the results of the RECORD trial at the American Diabetes Association meeting in New Orleans. The study monitored 2,220 patients who received Avandia (rosiglitazone) as a supplement to metformin, normally the first-line drug in diabetes 2 treatment, or sulphonylurea. 2,227 other patients received a combination of metformin and sulphonylurea without Avandia.

GlaxoSmithKline said the findings confirmed that “cardiovascular hospitalization and cardiovascular death was not statistically different between the two groups after an average of 5.5 years of therapy.”

Philip Home, a professor at Newcastle University in Newcastle Upon Tyne in the UK and chairman of the RECORD trial, said the data “leads us to conclude that rosiglitaone carries no increased risk of overall cardiovascular death or hospitalization compared to the most commonly used diabetes medicines…which have been used for decades.”

However, an editorial by Toronto doctors Ravi Retnakaran and Bernard Zimman in the medical journal The Lancet, in which the RECORD results were published, raised doubts about the study’s accuracy. The doctors wrote that “definitive conclusions about the relation between rosiglitazone and cardiovascular disease remain elusive, owing to study limitations.”

The overall rate of cardiovascular problems in the RECORD patients was unusually low, and ten percent more of the Avandia patients were taking statins – cholesterol fighting drugs that effectively reduce the risk of heart attack.

Moreover, 45 percent of the RECORD participants dropped out of the study at some point, yet Glaxo maintains that the high dropout rate did not influence the results. Doctors Retnakaran and Zimman believe that dropout rate alone compromises the trial’s conclusions.

Steven E. Nissen, M.D. of the Cleveland Clinic said that “it is impossible to assess the safety of a drug when patients are not actually taking it.”

SOURCE: Avandia Recall › Doctors and critics doubt the accuracy of Avandia study