Editorials

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
  1. Shari D Bolen, assistant professor of medicine, epidemiology, and biostatistics13,
  2. Nisa M Maruthur, assistant professor of medicine and epidemiology46
  1. 1Division of General Internal Medicine, Department of Medicine, The MetroHealth System/Case Western Reserve University, Cleveland, OH, USA
  2. 2Center for Health Care Research and Policy, Case Western Reserve University at The MetroHealth System
  3. 3Department of Epidemiology and Biostatistics, Case Western Reserve University
  4. 4Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
  5. 5Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
  6. 6Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
  1. Correspondence to: S D Bolen sdb73{at}case.edu

Latest data are reassuring about pancreatic cancer, less so about heart failure

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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