Actos: Are the Benefits Worth the Risks?

Boston, MAA new diabetes study has found positive effects of Actos, but the risk of Actos side effects may still outweigh the benefits. The study found that Actos can slow the progression of diabetes, but it still found evidence of Actos side effects. With rival drug Avandia's use being severely restricted, many patients are turning to Actos, but there are still concerns about the link between Actos and heart failure or Actos and bladder cancer.

The study was published in The New England Journal of Medicine (03/24/11) and examined whether Actos would slow the progression from pre-diabetes to diabetes. One group of participants was put on Actos while the other was given a placebo. Researchers found that fewer patients in the Actos group developed diabetes after approximately two-and-a-half years than those in the placebo group. Of participants, at the follow-up, 2.1 percent of those who used Actos had developed diabetes compared with 7.6 percent in the placebo group. It is worth noting, however, that this means that more than 90 percent of the patients in both groups did not develop diabetes by the follow-up.

Researchers noted, however, that patients who were given Actos suffered from side effects, including weight gain and edema (fluid buildup). They concluded, "As compared with placebo, pioglitazone [the generic name for Actos] reduced the risk of conversion of impaired glucose tolerance to type 2 diabetes mellitus by 72% but was associated with significant weight gain and edema."

Furthermore, three people in the Actos group died, compared with one in the placebo group. This does not mean that Actos killed participants, but if the drug is being taken to save lives, then it does not appear to be doing that either.

Actos has received more positive focus now that Avandia's use has been severely restricted. The question, however, is whether or not people should take Actos to prevent diabetes. Many doctors say that monitoring diet and exercise help prevent diabetes and do not come with a risk of side effects.

Meanwhile, the FDA has announced it is reviewing Actos for a possible link to bladder cancer and a possible link to rhabdomyolysis, a rare condition in which the patient's muscle fibers deteriorate and are released into the blood flow. Rhabdomyolysis can cause kidney failure.