Skip to main content

First, It Was Avandia... Now, Actos

In its mad rush to maximize profits, Big Pharma will go to great lengths to rush their products to market – then dupe low-information Americans into believing that these products are the only alternative they have for what ails them. They will say this even when low-risk, low-cost alternative treatments such as diet, exercise and lifestyle changes are effective (have you noticed how pharmaceutical ads in recent years often warn patients that "it may not be enough"?)

 

Take Type 2 diabetes, for example. This is a condition that is quite distinct from Type 1, or "childhood-onset" diabetes. The results are the same, but the cause  is different; while the latter is the result of a pancreas that simply does not function and thus does not produce insulin, the former is due to a weak cellular response to insulin that is produced by a functioning pancreas. (For a more technical explanation, read this post from 12 September.)

 

Over the years, there have been several drugs used to treat the problem of Type 2 diabetes by targeting different systems related to the production insulin and/or the metabolism of glucose. However, virtually every one of these have had side effects ranging from annoying to fatal.

 

For centuries, French lilac was used to treat what was once known as the "sweetwater sickness." In the 1920s, researchers discovered a compound in this plant, known as guanidine, that could lower glucose levels. The result was biguanidine medications, three of which were phenformin, buformin and metformin (sold under the brand names DBI, Silubin and Metrol, respectively). All of these were found to increase the risk of lactic acidosis (guanidine is alkaline) – which basically starves the body's cells of oxygen and were banned in the 1970s.

 

The first anti-diabetic drugs to be commonly used however were sulfonylureas. Unlike guanidines and glitazones which stimulate cells (such as Avandia and Actos), sulfonylureas act to stimulate the pancreas, coaxing it to produce more insulin. Since excess insulin in the bloodstream causes weight gain, it was no surprise that patients experienced this side effect. However,  sulfonylureas are also associated with birth defects as well as cardiovascular problems. A non-sulfonylurea drug with a similar mechanism is meglitinide, which is still sold under the brand names Prandin and  Starlix. One of the problems with these drugs is that they apparently work too well; patients wind up suffering from hypoglycemia, which can be fatal. In addition, Prandin is associated with the development of  thyroid and liver tumors.

 

Alpha-glucosidase inhibitors take a different approach altogether. Instead of acting on the pancreas or cellular insulin receptors, these medications slow down the digestive process, reducing the release of glucose into the bloodstream. While the side effects here are not necessarily fatal, they can be annoying and embarrassing; excess flatulence and diarrhea are common. 

 

An alternative to these (known as secretagogues, since they attempt to coax the pancreas to "secrete" more insulin) are the peptide analogues. These include exenatide (sold as Byetta or Januvia) and liraglutide (Victoza). The former can cause a wide range of gastrointestinal problems  as well as pancreatitis and a heightened risk of thyroid cancer.

 

The potential risks associated with Avandia and Actos are well known and well documented here at Levin-Pappantonio. However, despite the fact that lawsuits are mounting (and may soon turn into a class action), Actos manufacturer Takeda Pharmaceuticals is moving ahead with the production of its next anti-diabetic drug – which is a compound of  Actos and a secretogogue, Nesina.

 

Talk about the worst of both worlds...are there any safe treatments for Type 2 diabetes? Next week, I'll discuss some alternatives that Big Pharma would rather you didn't know about.

 

Sources

 

N/A. "Diabetic Drug Linked to Deaths Banned. Boca Raton News, 26 July 1977.

 

Reinberg, Steven. "Popular Diabetes Drug May Raise Pancreatic Cancer Risk, Study Suggests." USA Today, 23 September 2011.

 

Learn more about Actos and Bladder Cancer

Customize This