AHA/ACC warn that TZDs should be taken cautiously

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A joint science advisory statement issued by the American Heart Association (AHA) and the American College of Cardiology (ACC) warn about the use of thiazolidinediones (TZDs) as a treatment for diabetes after a report from the U.S. Senate Finance Committee outlined the drug's potential to cause adverse cardiac events.

According to the statement, limited research currently exists regarding the safety and efficacy of TZDs such as pioglitazone (Actos, Takeda) or rosiglitazone (Avandia, GlaxoSmithKline). According to the AHA/ACC, these drugs may have the potential to increase heart risks in diabetes patients.

"Research is ongoing and more is needed to understand which agents, including TZDs, work best for diabetes control," said Clyde Yancy, MD, president of AHA.

The advisory suggested that metformin, a glucose-lowering medication, be the first drug of choice for diabetic patients. The advisory said that if a TZD is considered as treatment, it should be used with caveats and not with the expectation to lower the risk of heart attack or stroke in patients.

Although the advisory said that there is not enough data to clinically support the use of TZDs, the joint statement advises clinicians to consider keeping patients currently taking a TZD on the drug if they have achieved HbA1c control.