For Diabetes Drugs, Old and Cheap Are Good

Wall Street Journal

For Diabetes Drugs, Old and Cheap Are Good

Old, cheap diabetes drugs — especially a generic called metformin — are as good as or better than newer, more expensive drugs at lowering blood sugar. And for the most part the older drugs don’t carry more serious side effects than the newer ones, according to a [1] review of more than 200 studies.

The analysis, funded by the federal government, looked at oral medicines given to patients with type-2 diabetes.

The finding, published today in the Annals of Internal Medicine, is consistent with [2] recommendations from the American Diabetes Association and other groups that call for starting patients on metformin before trying other drugs. When metformin alone doesn’t work, it’s often prescribed in combination with other medicines.

Metformin, also sold under the brand name Glucophage, costs about $100 per year, and “looks to be the safest” of the drugs, the study’s lead author [3] told the Associated Press.

But it does carry a rare side effect called lactic acidosis, and isn’t recommended for patients with heart failure or moderate kidney disease.

Also reviewed in the study was an old class of drugs called sulfonylureas and several newer classes, including TZDs, the class that includes GlaxoSmithKline’s Avandia.

Avandia Bonus: The FDA is waiving conflict-of-interest rules to allow several physicians to sit on an advisory committee meeting later this month, Bloomberg [4] reports. The committee will discuss the possible [5] heart-attack risk associated with Avandia, and could recommend anything from waiting for more data to removing the drug from the market. Many top academic physicians have financial connections to the pharmaceutical industry, and the FDA often waives conflict of interest rules for its advisory committees. But the practice has been attacked by some who claim that the agency is too cozy with the drug industry.