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Analysis weighs benefits, risks of Actos

Rating

4 Star

Analysis weighs benefits, risks of Actos

Our Review Summary

A recent analysis suggests a newer diabetes drug, Actos, may lower risk of death, heart attack, or stroke compared to taking a sugar pill or other types of diabetes drugs.  But despite the findings, the story makes it clear that many experts consider these newer types of drugs as second line therapy, due to their higher risk of heart failure and higher costs compared to older drugs that are also effective.  The story even includes a quote telling readers that no one is suggesting taking these newer drugs to reduce chance of death, heart attack, or stroke; rather, the analysis was undertaken in an attempt to further understand risk-benefit trade-offs of Actos, particularly in light of recent safety concerns about another drug in the same family (rosiglitazone).  The story met most criteria, including describing the type of evidence, costs, availability and novely of the drug, quantifying benefits, and obtaining independent input, or at least describing potential conflicts of interest of sources of information.  The story could have been improved with a further discussion of potential harms of treatment (such as quantifying risk of heart failure) and by fully discussing alternate treatment options, including diet, exercise, and weight loss to manage risk factors for diabetes complications. 

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

While absolute costs of the new drug are not given, the story does tell readers that older, cheaper drugs are less than 20 cents a day, which is 10 times less than the cost of the newer drug. 

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story provides absolute rates of death, heart attack, or stroke in those taking Actos and in those taking placebo or other diabetes drugs. We applaud the reporter for using absolute -not relative – rates.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Not all potential harms associated with Actos are mentioned.  Heart failure is one harm and is mentioned.  Yet, no absolute data is provided about how often heart failure occurs or how serious it may be.  There are also other harms that are not mentioned at all.

Does the story seem to grasp the quality of the evidence?

Satisfactory

The article tells readers the findings are based on a review of pooled results from 19 studies that compared the drug to either placebo, or sugar pill, or other diabetes drugs.  The article also mentions the study was funded by the drug manufacturer. 

Does the story commit disease-mongering?

Satisfactory

There is very little information about diabetes given, but one key point is mentioned–that heart attacks are a leading cause of death in people with diabetes.  This fact provides context to the discussion of risks and benefits of these newer drugs.  Although more background info could have been provided about diabetes itself, there is nothing misstated or embellished. 

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story obtains multiple sources of information, including from at least one source not connected with the research. 

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story mentions at least one drug alternative (metformin) to the newer drugs, but fails to mention others.  The story also fails to mention lifestyle interventions, such as diet, exercise, and weight loss to help control blood sugar and other risk factors for diabetes complications. 

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The article describes that the diabetes drug studied (Actos or pioglitazone) has been around and used by more than 7 million people since its introduction in 1999. 

Does the story establish the true novelty of the approach?

Satisfactory

The story tells readers Actos is part of a newer class drugs and tells readers this drug has been on the market since 1999. 

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story obtains quotes from sources not linked to the research and so it does not appear that this relies solely on a press release. 

Total Score: 8 of 10 Satisfactory

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