March 17, 2014
Incretins Receive Pass for Questionable Safety
I think the title of the article says a lot - No Compelling Evidence Linking Incretin Therapies, Pancreatic Cancer. The word compelling is characterized by this definition (of an argument, evidence, etc) convincing. The U.S. Food and Drug Administration (FDA) and its European counterpart started reviews last year of the medications, which came on the market less than a decade ago, after a study suggested a safety concern.
Now I have concerns – only one year of reviews – is not long enough to be sure there are no problems and I suggest that people continue to be cautious. Several others have written blogs about this, including one by David Mendosa titled safety-diabetes-drugs. While I think this is good, call me a skeptic. Pancreatitis pain is often not expressed by many patients. They want something to bring their blood glucose levels under better management and they often think that then their pancreatitis will go away.
It is true that the incretins do spur the pancreas to produce more insulin after meals. However, if the pancreas is losing the ability to produce more insulin, is this doing any value by stressing the pancreas even further? This is the reason people should not leave insulin as the medication of last resort. Our doctors are always pushing people to take more oral medications.
The New England Journal of Medicine says that the European and FDA say that reviews of animal and human studies had found no treatment-related adverse effects on the pancreas. What is not disclosed is how healthy were the rodents used and were healthy type 2 humans used in the studies. This is often the case and why I have no faith in the studies.
Then the last paragraph even creates more doubt when it says, “Although the review ''provides reassurance,'' the agencies ''have not reached a final conclusion'' about whether the drugs can cause pancreas problems and will ''continue to investigate this safety signal,'' the authors write. Meanwhile, the drugs' labels appear adequate, the agencies conclude.”