Repurposing Avandia

Largely because of a controversial 2007 meta-analysis by the controversial and controversy-stirring Steve Nissen, sales of the antidiabetic drug Avandia (rosiglitazone) dropped more than 50%, from about $3 billion in 2006 to $1.2 billion in 2009. As an apparent consequence, the drug's manufacturer, GlaxoSmithKline, has been searching for an alternative indication for the product, especially given that the drug is at risk of being pulled from the market. In addition, the use patent for Avandia in type 2 diabetes (the drug's primary indication) expires in 2 years.

Unfortunately for GSK and people with Alzheimer disease, trials of an extended-release version of the drug (the REFLECT studies) failed to show any cognitive benefits with Avandia when added to or compared with the standard treatment of donepezil (Aricept; Pfizer) or placebo. Last year, GSK announced that it was abandoning its development of Avandia for AD.

But plenty of other GSK-sponsored and non-GSK trials of Avandia have been conducted or are ongoing. These include studies in asthmatic smokers,* ulcerative colitis,* HIV-related lipoatrophy, and chronic kidney disease. Avandia's effects on preventing or treating certain types of solid tumors also have been or are under investigation.

* In addition to mitigating insulin resistance, Avandia appears to have anti-inflammatory properties.