The widely used diabetes drug Avandia should remain on the market in the U.S., American government health advisers recommended Monday, saying evidence of an increased risk of heart attack doesn't merit removal.

The nonbinding recommendation to the U.S. Food and Drug Administration came on a majority vote by the panel. The tally wasn't available.

"We're being asked today to take a very draconian action based on studies that have very significant weaknesses and are inadequate for us to make that kind of decision," said Rebecca Killion, a diabetic from Bowie, Md., who serves as the panel's patient representative.

However, in an earlier 20-3 vote, the panellists said that available data show the drug does increase heart risks. Panellists said the drug's warning label should be updated and there should be additional study.

Earlier, FDA scientist Dr. David Graham told the joint panel of experts that the drug's heart risks, combined with its lack of unique short-term benefits in helping diabetics control blood sugar, meant continued sales were not justified.

The manufacturer, GlaxoSmithKline PLC, argued that there is no increased risk, citing its own analyses of studies of Avandia, also called rosiglitazone.

"The number of myocardial infarctions is small, the data are inconsistent and there is no overall evidence rosiglitazone is different from any other oral antidiabetes agents," said Dr. Ronald Krall, the company's senior vice-president and chief medical officer.

The FDA convened the experts to consider whether Avandia should be restricted to use in select patients and branded with prominent warnings or removed altogether from sale. Previously, the FDA had said information from dozens of studies pointed to an increased risk of heart attack.

The FDA isn't required to follow the advice of its advisory committees, but usually does.

Health Canada doing own analysis

North of the border, Health Canada is doing its own analysis of study findings and has been following the FDA advisory panel presentations live through a weblink.

"Medical and scientific information is continuously evolving and the results of the advisory panel will be considered in Health Canada's assessment of Avandia, as will the findings of a number of scientific studies," media relations official Alastair Sinclair said in an e-mail.

"New information will be made public to Canadians and Canadian health-care professionals as soon as it is available."

He noted that indications for use of the product in Canada are already more restrictive than those approved in the United States. For instance, in Canada, Avandia is not approved to be used in combination with insulin.
  
In the U.S., about one million Americans with Type 2 diabetes use Avandia to control blood sugar by increasing the body's sensitivity to insulin.

That sort of treatment has long been presumed to lessen the heart risks already associated with the disease, which is linked to obesity.