Actos Recalls in France and Germany:
                                    A European clinical study by the French National Health Insurance plan found a statistically            significant risk of bladder cancer among 1.5 million diabetic patients taking Actos,            with the risk increasing for periods of treatment longer than one year. A study            by the French Medicines Agency found a 22 percent higher risk of bladder cancer            in approximately 155,000 patients taking Actos from 2006 to 2009, compared to 1.3            million patients not taking the drug. The French Agency for the Safety of Health            Products ordered an Actos recall in June 2011 in response. The German Federal Institute            for Drugs and Medical Devices followed shortly thereafter by advising physicians            not to prescribe Actos to diabetic patients. Actos has not yet been recalled in            other European countries.        
                    The European Medicines Agency (EMA) issued an Actos alert in July 2011 based on            its review of bladder cancer risk. The EMA concluded that the benefits of Actos            outweigh the bladder cancer risk for a limited group of type 2 diabetics, and that            the small risk for these patients could be reduced by patient selection and exclusion,            with continued review of Actos safety and treatment efficacy.        
                            
                No Actos Recall in the United States:
                            The FDA has not issued a recall for Actos in the United States. In September 2010,            the FDA ordered an Actos safety review and continues to evaluate the results of            an ongoing ten-year study in the US of long-term risk of bladder cancer in approximately            193,000 diabetic patients. The five-year results so far have shown no overall increased            risk of bladder cancer from Actos use. However, a significantly increased risk of            bladder cancer has been associated with the highest Actos dosages and with taking            Actos for longer periods of time. In response, the FDA required updated Actos drug            label warnings and informed the public that taking Actos for more than one year            may be associated with an increased risk of bladder cancer. The FDA will continue            to update the public on the results of its review as new data becomes available.        
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