Diabetes Drug Avandia Could Increase Brittle Bone Risk
Scientists in the US have highlighted how a popular diabetes drug could make those taking it at a higher risk of developing brittle bone disease. The drug in question – GlaxoSmithKline’s Avandia (rosiglitazone) – is prescribed to patients with type 2 diabetes.
It was discovered during trials involving mice that Avandia – which acts to augment the properties of insulin – might be disrupting the formation of new bones.
Avandia was the subject of severe concern when, six months ago, an article published in the New England Journal of Medicine linked it to heart problems.
Combined, rosiglitazone, along with its counterpart pioglitazone, accounted for over 1.5 million prescriptions made out in the UK in 2006.
Avandia Drug Study Revealed More about Bone Formation
The most recent study – which was carried out at the La Jolla-based Salk Institute – provides more information than was previously known about how bone formation takes place.
The dual action of bone-destroying ‘osteoclast’ cells and bone-creating ‘osteoblast’ cells means that bone is involved in a constant process of regeneration. The two activities need to work in a balanced way to guarantee that the bones remain healthy, as well as durable enough to stand up to the rigours of life.
Based on this scenario, the US scientists discovered that Avandia, when administered to mice, acted to increase the activity of the osteoclasts, meaning that the bone destroying/bone creating relationship lost some of its usual balance.
Consequently, the mice’s bones began to become thinner.
Conversely, where Avandia’s genetic target could not be reached, the osteoclasts could not reach full maturity and therefore bone mass increased.
The scientists wrote in Nature Medicine of their discovery:
"These findings have potential clinical implications, as they suggest that long-term rosiglitazone usage in the treatment of type 2 diabetes and insulin resistance may cause osteoporosis, owing to a combination of decreased bone formation and increased bone resorption."
Despite this, they added that in diseases including rheumatoid arthritis and osteoporosis, alternative drugs could be manufactured to counter Avandia’s effect, and maybe encourage new bone to develop.
Results Due Soon from European Avandia Review
Avandia’s possible link with cardiovascular issues has prompted the European Medicines Agency to review the drug – with the results of this due to be announced soon.
Diabetes UK’s Dr Ian Frame described the new study’s findings as “interesting”. He continued: “We already know that bone fractures are more common in people with diabetes taking rosiglitazones. This research could help us to understand better the effect the drug may have on bone health.
“However, a lot more research is needed before we can conclusively link rosiglitazones to increased risk of various bone conditions in humans."
Source – Pharmaceutical International’s Health Reporter
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