A relatively new class of drugs called “incretin mimetics” have clear benefits for people suffering from diabetes, but many are wondering whether they also raise a person’s risk of pancreatic cancer. Incretin therapies mimic natural human chemicals called incretins that increase a person’s insulin levels to keep blood sugar in check.
Incretin agents have relatively few side effects compared to insulin and other diabetes medications, which can cause weight gain and hypoglycemia. However, all incretin therapies come with a risk of pancreatitis, a dangerous inflammation of the pancreas. The first incretin, Byetta, hit the market in 2005. Subsequently, the FDA found that of 30 reported cases of pancreatitis, 22 patients improved after stopping the drug. All incretins now carry a warning that they may cause pancreatitis.
The question whether the drugs also cause pancreatic cancer is still unanswered. Because pancreatic cancer is a risk associated with diabetes, it is difficult to determine whether these drugs are a contributing cause. In 2009, Peter C. Butler, an endocrinologist and researcher at the University of California began publishing a series of studies that found that incretin therapy made pancreas cells multiply in animal models and in pancreatic tissue from deceased human organ donors. He concluded that incretin therapy did not trigger cancer, but fueled growth like a growth hormone.
This study has been highly criticized, and the FDA, the American Diabetes Association, the National Institute of Diabetes and Digestive and Kidney Diseases all have said the link between incretin mimetics and pancreatic cancer is inconclusive. However, recently, a new analysis of the FDA’s database has found that pancreatic cancer was ten times more common among users of Januvia, a brand of incretin, than would be expected. Other brands also showed a correlation with an elevated rate of pancreatic cancer.
Since the FDA launched its investigation into incretin mimetics in 2013, there have been many lawsuits filed against drug makers. In November of 2015, a federal judge in California threw out more than 744 lawsuits filed around the country alleging that drug makers failed to warn consumers of the risks of incretin mimetics. He found that drug makers were shielded from liability because the FDA would not have allowed them to add “pancreatic cancer” to the drugs’ labels. The case is currently being appealed.
Diabetes is an epidemic in this country, and the use of incretin mimetics is becoming even more prevalent. There are currently over nine approved compounds on the market, and the drug is now being used to treat other health conditions, including obesity. Incretin mimetics are currently in testing for their usefulness in treating Alzheimer’s disease, polycystic ovary syndrome, heart failure and cocaine addiction.
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