The issue of TZD (e.g., Avandia, Actos) and their link to bone fractures has been discussed for several years. It seems to be a class issue, meaning that no drug in the category is exempt, although some may produce more fractures than others. A recent utilization study by Henry Ford Health System further emphasizes this problem. Below are excerpts published by Healthcare Daily Data Byte in regards to this issue.
A Henry Ford Hospital study finds women with type 2 diabetes who take a commonly prescribed class of medications to treat insulin resistance may be at a higher risk for developing bone fractures. To determine the relationship between thiazolidinedione (TZD) use and in patients with type 2 diabetes, researchers conducted a retrospective study from January 2, 2000 to May 31, 2007 of 19,070 Henry Ford patients. During the study period, 4,511 patients had at least one prescription filled for a TZD. The researchers used electronically maintained medical claims data to identify non-traumatic bone fractures. The increased risk in women appeared after approximately one year of TZD use. TZDs, such as pioglitazone and rosiglitazone, help keep blood glucose levels on target by decreasing insulin resistance and making body tissues more sensitive to insulin's effects. TZDs also cut down on the amount of glucose made by the liver in patients with type 2 diabetes.
"Fractures are just one of a growing number of problems associated with these medications. Henry Ford and other researchers have previously found that this class of medications also can increase risk of congestive heart failure hospitalization," says study senior author L. Keoki Williams, M.D., M.P.H., center for health services research and department of internal medicine at Henry Ford Hospital. Dr. Williams also notes that there are other medication options available to treat insulin resistance in patients with type 2 diabetes. "TZDs may put some patients at increased risk for other health issues, and I encourage patients to talk with their physician about other suitable options," says Dr. Williams. "If the physician feels the patient should be placed on a TZD, routine screening for bone loss and prophylactic therapy to prevent bone loss and fractures may also be needed."
Research Study Source: http://www.henryfordhealth.org/body.cfm?xyzpdqabc=0&id=46335&action=detail&ref=1056
