Should we be reassured about sitagliptin?

New drugs for the treatment of diabetes have had to fight hard to prove their safety. The latest class of drugs causing concerns is the dipeptidyl peptidase-4 (DPP-4) inhibitors. Current evidence suggests that these drugs increase the risk of pancreatitis and they are undergoing close study for evidence of sufficient safety to warrant their continued use.1 In a linked paper (doi:10.1136/bmj.f2267), Eurich and colleagues contribute to the growing evidence base regarding sitagliptin and related drugs and provide some evidence of their safety.2

Sitagliptin was approved by the US Food and Drug Administration (FDA) in 2006 as the first in a new class of antidiabetic drugs, the DPP-4 inhibitors. It was approved for use as monotherapy or combination therapy, with diet and exercise, for treatment of type 2 diabetes. During the first three years after approval, the FDA received 88 case reports of acute pancreatitis. This prompted a revision of the …