Studies Evaluate Safety of New Diabetes Drugs

Incretin-based medication may not increase the risk of developing pancreatic cancer, but dipeptidyl peptidase-4 (DPP-4) inhibitors may increase the rate of hospital visits related to heart failure, according to 2 new studies.

The first study investigated whether patients with type 2 diabetes who are taking incretin-based medications or sulfonylureas are at a higher risk of developing pancreatic cancer.
__________________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Surgery vs Medication: Which is Better for Type 2 Diabetes?
Identifying the Principles of Diabetes Treatment
__________________________________________________________________________________________________________________________________________________________________________

To conduct their study, researchers assessed data from 972,384 patients with diabetes who started taking antidiabetic medication between January 2007 and June 2013 in Canada, the United States, and the United Kingdom.

After a median 1-to-3-year follow-up, researchers found that 1221 patients were diagnosed with pancreatic cancer, but incretin-based medications such as DPP-4 inhibitors and saxaliptin didn’t influence patients’ risk of developing it.

“In this large, population-based study, the use of incretin-based drugs was not associated with an increased risk of pancreatic cancer compared with sulfonylureas,” researchers concluded. “Although this potential adverse drug reaction will need to be monitored long term owing to the latency of the cancer, these findings provide some reassurance on the safety of incretin-based drugs.”1

The second study assessed whether patients with type 2 diabetes had a higher risk of heart failure when taking DPP-4 inhibitors.

To conduct their study, researchers included 43 controlled trials and 12 observational studies—which compared DPP-4 inhibitors with placebo, lifestyle modification, or active antidiabetic drugs and reported heart failure as an outcome—in their meta-analysis.

After analyzing the data, researchers found that DPP-4 inhibitor use might not increase the risk of heart failure in patients with type 2 diabetes. However, evidence from some trials suggested an increase in hospital visits related to heart failure.

“The relative effect of DPP-4 inhibitors on the risk of heart failure in patients with type 2 diabetes is uncertain, given the relatively short follow-up and low quality of evidence,” researchers concluded. “Both randomized controlled trials and observational studies, however, suggest that these drugs may increase the risk of hospital admission for heart failure in those patients with existing cardiovascular diseases or multiple risk factors for vascular diseases, compared with no use.”2

—Amanda Balbi

Reference:

  1. Azoulay L, Filion KB, Platt RW, et al. Incretin based drugs and the risk of pancreatic cancer: international multicentre cohort study. BMJ. 2016;352:i581. doi:http://dx.doi.org/10.1136/bmj.i581.
  2. Li L, Li S, Deng K, et al. Dipeptidyl peptidase-4 inhibitors and risk of heart failure in type 2 diabetes: systematic review and meta-analysis of randomised and observational studies. BMJ. 2016;352:i610. doi:http://dx.doi.org/10.1136/bmj.i610.