Rosiglitazone More Dangerous Than Pioglitazone for Elderly Diabetics

Two oral medications for type 2 diabetes, rosiglitazone (Avandia) and pioglitazone (Actos), have both been shown to have benefit and potentially high risk. A recent study has concluded that rosigilitazone is significantly more dangerous for older diabetics.

Rosiglitazone and pioglitazone are both part of a wider spectrum of oral medication known as thiazolidinediones. 1997 marked the release of these types of medications as a treatment to control blood sugar and decrease insulin resistance. Rosiglitazone and pioglitazone were released in 1999 after being shown to be extremely effective in decreasing insulin resistance in clinical studies, and became two of the more popular and most-prescribed thiazolidinediones on the market.

Both drugs soon received attention, however, as potential risk factors for heart disease, resulting in warnings for those with previous heart conditions, on the drugs boxes. It’s recently been concluded by a team of researchers that rosiglitazone is riskier than pioglitazone for elderly patients.

28,361 elderly (over 65 years of age) diabetic patients were analyzed in the study. Approximately half were taking pioglitazone, while the other half were being treated with rosiglitazone. After 380 days, there were 1,869 deaths between the two groups. It was observed that patients taking rosiglitazone had an increased risk of heart failure (13% increase), as well as a general 15% increased risk of death, over pioglitazone. This is the first time either of these drugs has been connected to increased mortality in general. “Although previous studies have indicated that the increased risk with rosiglitazone use resides predominantly in cardiovascular outcomes, the present study suggests that differences in all-cause mortality [death] risk may be even more important to consider in elderly patients,” state the authors.

While both of these drugs already were known to be potentially dangerous, this study better affirms and extends the potentially negative implications for elderly diabetics taking rosiglitazone. The authors conclude that “this study confirms the safety concerns that have been raised for rosiglitazone compared with pioglitazone, which, in turn, also cannot be considered a very safe drug given its well-documented effect on the risk of congestive heart failure.”

Source: Defeat Diabetes Foundation: Winkelmayer, Wolfgang. Brown-Ayers, Holly. JAMA news release. November 2008.