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KMID : 0927720100110040247
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Korean Clinical Diabetes
2010 Volume.11 No. 4 p.247 ~ p.253
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What Can We Learn From the Story of Avandia?
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Kim Hee-Young
Kim Sin-Gon
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Abstract
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Avandia was welcomed by clinicians upon its introduction in 2000. The results of clinical studies indicated that Avandia not only improves glucose level, but also has beneficial effects on blood pressure, dyslipidemia, and inflammatory markers related to atherosclerosis. As a result, it was expected that Avandia would reduce the risk of cardiovascular disease, reflected in the marketing slogan, ‘beyond glycemic control.’ However, it was found that the positive data observed for surrogate markers did not necessarily correspond to positive clinical outcomes. Furthermore, the result of a meta-analysis in 2007 indicated that Avandia increases the risk of myocardial infarction. This result was considered controversial by many clinicians because meta-analyses do not always provide a clear answer. In addition, it seemed that the controversy could be influenced not only by scientific evidence but also by conflicts of interest. The lessons of Avandia also indicate that value estimation is more important than evidence and that scientists must consider the social impacts of their work.
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KEYWORD
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Avandia, Cardiovascular disease, Conflicts of interest, Meta-analysis, Social impact, Surrogate markers, Value
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