The safety of incretin based drug treatments for type 2 diabetes
BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i801 (Published 17 February 2016) Cite this as: BMJ 2016;352:i801
- Shari D Bolen, assistant professor of medicine, epidemiology, and biostatistics13,
- Nisa M Maruthur, assistant professor of medicine and epidemiology46
- 1Division of General Internal Medicine, Department of Medicine, The MetroHealth System/Case Western Reserve University, Cleveland, OH, USA
- 2Center for Health Care Research and Policy, Case Western Reserve University at The MetroHealth System
- 3Department of Epidemiology and Biostatistics, Case Western Reserve University
- 4Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- 5Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- 6Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
- Correspondence to: S D Bolen sdb73{at}case.edu
The incretin based drugs (dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 receptor agonists) are one of several options for glucose lowering in people with type 2 diabetes who are already taking (or unable to take) metformin.1 As with other antidiabetic drugs, the long term safety of these drugs remains unclear. Studies by Azoulay and colleagues (doi:10.1136/bmj.i581) and Li and colleagues (doi:10.1136/bmj.i610) in this issue provide updated evidence about incretin based treatments and the risk of pancreatic cancer and heart failure.2 3
In 2013 the Food and Drug Administration and European Medicines Agency undertook investigations of the possible link between incretin based treatments and pancreatic cancer owing to post-marketing reports suggesting higher rates of pancreatic cancer with these drugs,4 and a study suggesting abnormal pancreatic histology among users of incretin drugs versus non-users.5 These investigations revealed no clear causal role …
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