Diabetes Study Questions Expensive Treatments

Courtesy of Wall Street Journal

Aggressive use of expensive diabetes drugs and stents did no better than cheaper treatments at preventing deaths, heart attacks or strokes in a large study of diabetics with heart disease. The study, sponsored by the National Institutes of Health and several drugmakers, is the latest to humble fancy new treatments by finding them no better than older medicines at preventing the deadly consequences of major diseases. The results add to a debate about alleged overuse of stents, made by companies including Abbott Laboratories, Boston Scientific Corp. and Johnson & Johnson, and controversial diabetes drugs from GlaxoSmithKline PLC and Takeda Pharmaceutical Co.

Funding for similar "comparative effective" studies have just been given a big boost. These bake-offs between competing therapies for the same condition have been hailed as a possible answer to wasteful health-care spending in the U.S. Washington allocated $1.1 billion for such research in the economic-stimulus bill passed in February. The findings could make it more difficult for stents to sustain a recent sales rebound that followed a drop-off caused by a 2007 study that questioned their effectiveness. The results also pose new questions for GlaxoSmithKline's Avandia, a diabetes drug already hurting because of worries about serious side effects; and for Takeda's Actos, an Avandia rival that has picked up market share in the wake of Avandia's problems.

"The results show that it really didn't matter at all which treatment you had" in terms of deaths, heart attacks and strokes, said Trevor Orchard, an epidemiologist at the University of Pittsburgh who helped run the trial, which is called BARI 2D. "We're a little disappointed that there was not a clear mortality benefit for any of the treatments," he said. The results were unveiled at a big diabetes conference Sunday. Patients who took Avandia or Actos, or other drugs aimed at helping the body use insulin better, had an 11.8% death rate over five years, compared with 12.1% for those taking insulin -- a statistical dead heat. Patients who had an immediate stenting angioplasty, a $15,000 procedure to open a clogged artery, had a 10.8% death rate over the five-year study period, compared with 10.2% for those who took generic medicines and waited. For those with more severe heart disease, the study compared an immediate heart-bypass surgery -- instead of the less-invasive stenting -- against pills. There, the bypass procedure won out.

Steve - recent research has also found similar findings with regard to hypertension. Obviously, we see a pattern forming. Many respond as well to older, cheaper treatment as they do to newer, more expensive treatment.