Avandia - the next Vioxx?

In two studies published in JAMA today, it appears that a popular class of drug for diabetes, known as thiazolidinedione (popular brand names = Avandia [rosiglitazone] and Actos [pioglitazone]) is causing some heart problems. Avandia was found to increase risk for heart attack by 42% and double the risk of heart failure. Actos also was found to increase the risk of heart failure, although it reduced risk of heart attack, stroke and death.

Actos and Avandia are used most often in the treatment of type 2 diabetes. The drugs act on similar mechanisms to lower glucose (blood sugar) levels in the body. They can be prescribed alone, or in conjunction with other therapies, such as insulin.

This is not the first time research has suggested these drugs may cause serious cardiac events. This past May, the New England Journal of Medicine published two studies that also revealed Avandia caused some heart problems. In response, a federal advisory panel met to discuss the drug and voted to keep it on the market. The FDA also placed stricter warnings on both Avandia and Actos in June.

Does this sound familiar? Drs. Solomon and Winkelmayer seem to think so. They wrote a great piece on common threads between the Vioxx case and the current findings on Avandia. It seems the jury is still out, because at present GlaxoSmithKline is keeping Avandia on the market. However, if this does become another Vioxx, let's hope GSK doesn't wait too long to do the right thing.

Meantime, if you're taking Avandia or Actos, you may want to discuss this new research with your health care provider. You also want to remember that good nutrition, exercise, and maintaining a healthy weight are also important for managing your type 2 diabetes.

FREE Antibiotics (yes, your contacts are working)

Although this blog is primarily dedicated to relaying research findings, every now and then a story will capture my interest that I have to share.

This week, Publix (a major supermarket in the South and one I used to frequent when I lived in Athens, GA) announced that they will be offering a FREE prescription drug program at all of its 684 pharmacies for the 7 following antibiotics: Amoxicillin, Cephalexin, Sulfamethoxazole / Trimethoprim (SMZ-TMP), Ciprofloxacin (excluding ciprofloxacin XR),
Penicillin VK, Ampicillin, and Erythromycin (excluding Ery-Tab).

Anyone (that's right, anyone - no income or insurance requirements to be met) who has a prescription can receive up to 14 day's worth of the above antibiotics, which will be filled free of charge. Furthermore, Publix is not limiting the number of prescriptions customers may fill. So if you get a sinus infection every month for the rest of the year and need antibiotics each month, you can get your medicine for free each time. (Of course, if that's the case, I might recommend a new doctor.)

As a researcher who studies low-income families, I am thrilled that Publix has taken this step. There are so many documented cases of families choosing among rent, food, and medicine. In fact, next week a student and I will be presenting on unmet health care needs at a conference on rural women's health sponsored by the Office of Women's Health. One of our findings in this low-income group was that the women with acute needs (i.e., unexpected illness or injury) did not fill their prescriptions. There will be more to come on our research next week. For now, I'm excited about this trend of companies stepping up to help families meet their economic and health care challenges. And, if you live in Alabama, Florida, Georgia, South Carolina, or Tennessee, find the Publix nearest you and take advantage of this great opportunity.