Internists most likely to switch patients off Avandia

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Though the FDA has yet to advise on the cardiovascular safety of GlaxoSmithKline's Avandia type 2 diabetes drug, some physicians are taking matters into their own hands.
Internists said they will switch more than half their type 2 diabetes patients currently on Avandia to another therapy, according to research from GfK Market Measures' Event Flash.
“This sharply contrasts with general/family practitioners and endocrinologists who expect to switch less than half of their patients,” said Anna Marie Napolitano, VP, leader, GfK Market Measures' Cardiology Practice.
The news of Avandia’s effect on cardiovascular risk has led to a congressional probe, and the FDA plans a hearing to discuss cardiovascular safety of the class and Avandia on July 30. In the meantime, diabetes experts have advised users of the drug to speak with their doctors and not to immediately discontinue use.
But the news of Avandia’s effect on cardiovascular risk has prompted some doctors to act. In another finding from the GfK study of 200 physicians who see no fewer than 10 type 2 diabetes patients per week, about a third of internists reported they are reluctant to prescribe Takeda’s Actos or any other product containing Actos, which is in the same drug class as Avandia, compared to about a quarter of general/family practitioners and endocrinologists.
Safety concerns have been building since the May 21 release of a New England Journal of Medicine meta-analysis finding that Avandia users are 43% more likely to suffer a heart attack than those taking other diabetes drugs. Since the paper appeared, GSK said prescriptions for Avandia have dropped 15% to 20%.
Reports of Avandia side effects to federal regulators also tripled, according to the Associated Press, due most likely to doctors’ low awareness of the drug’s possible role in their patients’ heart problems in the past.
“Now, patients and their doctors are much more aware of the possible link between Avandia and cardiovascular disease. This is good—this is going to help us going forward to determine whether or not this drug is safe,” a Vanderbilt University diabetes specialist told AP.
GSK has defended the drug, cautioning against drawing conclusions on adverse event data or on the NEJM meta analysis.
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