And Now: Avandia Linked to Poor Bone Health

Craig Stoltz Health Guide
  • The April 28 issue of the Archives of Internal Medicine has unsettling news for people with diabetes and osteoporosis: The popular diabetes medications Avandia and Actos are linked to broken bones.


    In the same issue of the journal, a different study linked the popular bone-health drug Fosamax with atrial fibrillation, an irregular heartbeat.


    Let's dig in.


    Five things you need to know:


    1. The link was discovered in a type of observational study known as "case control." This means researchers studying exisiting records divided patients with diabetes into two groups: those who'd broken bones and those who hadn't. Diabetics who had taken Avandia or Actos had over twice the risk of a bone fracture than diabetics who'd taken different drugs. This is an observation worth noting--but this type of study doesn't prove taking Avandia caused the broken bones. As usual: More research is needed.

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    2. Previous studies have found a similar link between this class of diabetes drugs and compromised bone health, suggesting this isn't a random finding. Still no fire, but more smoke.


    3. All of this follows a study published last May showing a link between taking Avandia and increased risk of heart problems. That study is controversial. It also lacked the power to prove cause and effect. But it's led many doctors to take patients off Avandia and switch them to older classes of diabetes drugs.


    4. For people with osteoporosis and diabetes: The Avandia/Actos study, combined with the finding about Fosamax, suggests it may be a good time to review your medication regimen. Viewed together the two studies suggest possible higher risk of bone problems if you are taking Fosamax for osteoporosis and Avandia or Actos for diabetes. No study has connected these two dots, but the potential double-whammy is worth a discussion with your doctor.


    5. For people with diabetes: Put in context of earlier findings linking Avandia to heart problems, the new study suggests there may be a second reason--compromised bone health--to consider a different medication.


    That's a lot to digest. Experts warn patients not to quit taking any meds without consulting with their doctors.


    For additional information, check in with the medical specialists and expert patients in our osteoporosis community.


    For more on diabetes, visit our area.

Published On: April 29, 2008