Keeping the Numbers Down for Diabetics
The care and treatment of diabetics is a rapidly growing segment of cardiovascular medicine. Those with diabetes need to maintain their glucose levels, keep their blood pressure stable and not be bogged down with a daily panoply of pills. Several articles over the past month attest to the needs of diabetics.

The RECORD trial found that the use of Avandia, a drug used to control glucose levels, was not associated with an increased risk of overall cardiovascular events. However, the trial confirmed earlier reports that Avandia increases the risk of fractures, especially in women, and should not be taken by those with heart failure.

Meanwhile, the STARR trial found that Avandia was not really beneficial for pre-diabetics without cardiovascular disease, but the drug had a modest effect on decreasing carotid media intima thickness in its patient population. The crux of these two trials is that physicians need to carefully assess their patients, before choosing Avandia for this therapy.

This patient population must get their glucose levels under control. A Journal of the American College of Cardiology study found that extreme highs or lows in glucose levels in diabetics with heart failure is strongly related to an increase in death.

As the population ages and patients live longer with a plethora of comorbid conditions, it is to their benefit that pharmaceutical companies develop combination drugs and drugs that can be taken weekly rather than daily.

Regarding hypertension, the FDA gave green lights to several new drugs: Tekturna HCT and the generic equivalent of Monopril HCT. Both are combination blood pressure drugs in a single pill.

Regarding insulin, the FDA is taking a closer look at exenatide, a once-weekly insulin therapy. An insulin treatment on the market, Lantus, got caught in the spotlight because three studies indicated it could pose a risk of cancer. The FDA send a warning about this, but it’s too early to draw firm conclusions about the association just yet.

The other good news is the approval by the FDA of prasugrel, the anti-thrombotic drug for use in patients undergoing PCI. The news was welcomed by the interventional community, as the FDA postponed its decision for a year.

On the heels of the approval, a report stated that prasugrel would cost nearly 20% more than the commonly used Plavix. The cost, along with the risk of increased bleeding, will determine how widespread prasugrel is used.

There is lots more news regarding cardiovascular pharmaceuticals. Please scan the entire list of portal stories included here.

And you can find more information about cardiovascular pharmaceuticals in our Healthcare TechGuide.

If you have any questions or comments regarding pharmaceuticals, please send them to me.

Chris P. Kaiser, Editor
Cardiovascular Business