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Two Type 2 Diabetes Drugs Under Investigation

Type 2 diabetes drugs

If you have type 2 diabetes and take medication, then you should know that two type 2 diabetes drugs are currently under investigation by the Food and Drug Administration (FDA) because they are associated with an increased risk of developing pancreatic cancer. If you are taking Januvia or Byetta, you should read on.

Could your diabetes drugs cause cancer?

Many of the estimated 25 million people in the United States who have type 2 diabetes take at least one, and often more, antidiabetes drug. Among them is Januvia (sitagliptin; Merck), an oral, once-daily antidiabetes drug that was approved on October 17, 2006. Another is Byetta (exenatide; Bristol-Myers Squibb), which is given via subcutaneous injection twice daily and was approved in April 2005.

Both Januvia and Byetta work in a similar way: they boost the body’s levels of GLP-1, a protein that is responsible for stimulating the pancreas to make more insulin while also preventing the liver from producing glucose if glucose levels are already high.

One of the drugs’ selling points is that they are not associated with weight gain, which is a problem with other antidiabetes drugs. They also can be taken alone or in combination with other drugs for type 2 diabetes, such as metformin, a first-line medication for type 2 diabetes that belongs to the biguanide class of drugs.

However, among the risk information about Januvia and Byetta is a warning concerning the possibility of pancreatitis. According to the Januvia website, “Serious side effects can happen in people who take Januvia, including pancreatitis, which may be severe and lead to death.”

This warning has been supported by research, including a recent report in JAMA’s Internal Medicine, which noted that people with type 2 diabetes who took one of the GLP-1 drugs had twice the risk of requiring hospitalization for acute pancreatitis within two months of starting their drug therapy when compared with patients who took a different type of antidiabetes medication.

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In fact, as far back as 2007, the FDA was aware of an increased risk of pancreatitis associated with Byetta and directed the makers to place information to that effect on the drug labels. Two years later, the FDA issued the same directive for the makers of Januvia and Janumet, which is a combination of sitigliptin and metformin.

Now the FDA is investigating the possibility of Januvia, Byetta, and other drugs in the same drug class (e.g., Victoza [liraglutide], Onglyza and Kombiglyze XR [saxagliptin], Nesina, Kazano and Oseni [alogliptin], Tradjenta and Jentadueto [linagliptin]) being associated with an increased risk of pancreatic cancer. Indeed, that makes sense, since having pancreatitis is a risk factor for this form of cancer, and both of these antidiabetes drugs are already associated with a higher risk of pancreatitis.

Should you be worried if you take either Januvia or Byetta? According to the FDA, it “has not concluded these drugs may cause or contribute to the development of pancreatic cancer.” The agency noted that “At this time, patients should continue to take their medicine as directed until they talk to their health care professional.”

Therefore, anyone who is taking these medications may want to talk to their doctor as soon as possible about changing to another medication. The FDA and researchers have known for years that these drugs are associated with an increased risk of pancreatitis, and now pancreatic cancer may be added to the list of potential dangers.

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FDA: FDA Drug Safety Communication: FDA investigating reports of possible increased risk of pancreatitis and pre-cancerous findings of the pancreas from incretin mimetic drugs for type 2 diabetes
Januvia website

Image: Morguefile