Avandia already carries a "black box" warning imposed by the Therapeutic Goods Administration (TGA) last year after research suggested it could raise the risk of heart attacks.
The drug's manufacturer GlaxoSmithKline (GSK) are now recommending that patients on the drug seek an immediate review with their doctor as recent research has revealed that Avandia may have ramifications for patients with heart related medical conditions.
The guidelines on which patients could benefit from the drug have been rewritten following safety fears raised by the latest research and further reduce the instances in which Avandia can be prescribed with other drugs.
Dr. Michael Elliott, Medical Director for GSK Australia, says patients taking Avandia should see their doctor first, rather than stopping the drugs on their own initiative.
Also affected by the changes is another drug, Avandamet, which is a combination of rosiglitazone and another anti-diabetes, metformin.
Avandia and Avandamet are not advised for use in patients who have a history of cardiac failure or angina or for patients with known ischaemic heart disease, particularly those who are currently being treated with nitrates or for patients with peripheral arterial disease.
The new guidelines say rosiglitazone is no longer recommended to be prescribed with insulin, or as a triple treatment in combination with metformin and another drug, sulfonylurea, which helps the pancreas make insulin.
An estimated 40,000 Australians are thought to be taking some form of rosiglitazone.
Further information can be accessed directly from GSK Australia on 1800 033 109.
While little improvement was seen in the pancreatic or liver tissue, in four of the six MSC-treated mice, intestinal tissues appeared almost identical to those of normal mice. Structural defects seen in the intestinal lining of untreated autoimmune mice had disappeared in the MSC-treated mice, an improvement seen in only one of six mice treated with regulatory T cells.
Analysis of the animal's lymph nodes revealed that MSC treatment produced a significant reduction in inflammation. Surprisingly, cell-tracking studies indicated that the MSCs - which were administered by infusion into the peritoneum, the membrane lining the abdominal cavity - moved into abdominal lymph nodes rather than to the intestine itself. The presence of MSCs was associated with a reduction of activated T cells and changes in other indicators of immune system activity, indicating suppression of the out-of-control immune reaction.
"The intestine may be an ideal site for MSC therapy, given its rapid ability to regrow tissue and its extensive local supply of lymph nodes; and the route by which the cells were administered may have ensured a greater amount of engraftment in gut-associated lymph nodes," explains Martin Yarmush, MD, PhD, director of the MGH Center for Engineering in Medicine and senior author of the study. "Before we can think about testing this approach in patients, we need to know more about long-term effects of MSC infusion - including immunosuppressive effects - and gain more understanding of how MSCs modulate immune cell activity in more realistic models of inflammatory bowel disease."
mgh.harvard/