I have to be disappointed in my
research sources. My (what I thought was my best source of oral
medications) resources have turned out to be a big disappointment to
me. I had been relying on the National Diabetes Information Clearinghouse (NDIC), which is part of the National Institute of
Diabetes and Digestive and Kidney Diseases (NIDDK), National
Institutes of Health (NIH), and a division of the U.S. DEPARTMENT OF
HEALTH AND HUMAN SERVICES (HHS). Apparently, the secretary of HHS,
Kathleen Sebelius could care less whether the NDIC is kept up to
date.
I am finding more and more information
in other sources and finding it necessary to maintain separate files
to keep up with many of the FDA approved oral medications. A good
example of this is the latest Dipeptidyl Peptidase-4 (DPP-4)
inhibitor to be licensed in the United States for the treatment of
type 2 diabetes, alogliptin (Nesina, Takeda Pharmaceuticals), has
been launched in 2013 and is the fourth DPP-4 inhibitor now approved
for use.
“Three formulations of alogliptin
were approved in January; as well as Nesina, the fixed-dose
combination of alogliptin and metformin hydrochloride (Kazano) and
alogliptin and pioglitazone( Oseni) are also now available in for use
with diet and exercise to improve blood glucose control in adults
with type 2 diabetes. The last two are mixed or combination
medications, which I missed in my blog, back on October 30 and Nesina
belonged in my blog on November 1.
Embarrassed? Yes, and there may be
other medications that I have let slip through the cracks. I have
not included medications approved in other countries, even though I
have readers in other countries. I am not prepared to monitor every
medication as I do not have the resources to do this, but I do
apologized for missing several approved in the USA.
“DPP-4 inhibitors have recently
been linked to a scare about a potential association with pancreatic
cancer. The latest data, however, suggest there is no confirmed link
yet, but that only time will tell whether this continues to be the
case.
The alogliptin/metformin combination
will carry a boxed warning about the risk for lactic acidosis. Two
post marketing studies will be required for this formulation. For
alogliptin/pioglitazone, the FDA is requiring enhanced
pharmacovigilance for severe adverse events. And, as with
pioglitazone, it will carry a boxed warning for heart failure.”
