Drugs for Type II Diabetes linked to Pancreatic Cancer

Two new drugs used in the treatment of type II diabetes have been found to be associated with a higher incidence of pancreatitis and pancreatic cancer. The drugs, Sitagliptin and Exenatide are linked with a six fold increase in the odds ratio for reported cases of pancreatitis, compared to other drugs used for diabetes. The study was conducted by researchers from the Larry L. Hillblom Islet Research Center at UCLA and the results have been published in the journal “Gastroenterology.” The researchers used the FDA’s database for adverse events reported between 2004 and 2009 among patients using these drugs, as well as earlier studies on animals, to reach the above mentioned conclusion.

Previous studies, done on animal models, had found that these medicines inadvertently promoted the growth of the pancreatic ducts that convey digestive juices from the pancreas to the gut. If the same holds true for humans, the risk for pancreatitis and pancreatic cancer can increase. An earlier research conducted by UCLA Hillblom Center researchers, and published in 2009 in the journal Diabetes, had hypothesized that these medicines increase the rate of formation of cells that line the pancreatic ducts resulting in pancreatitis.

Sitagliptin and Exenatide increase the actions of glucagon-like peptide 1 (GLP-1), a gut hormone known to be effective in lowering blood sugar in individuals with Type 2 diabetes. Sitagliptin, marketed as Januvia by Merck & Co. Inc., inhibits dipeptidyl peptidase-4 (DDP-4), an enzyme that degrades GLP-1. Exenatide, marketed as Byetta by Amylin Pharmaceuticals, acts as GLP-1 and resists the degradation by DDP-4. Apart from increasing the risk of pancreatitis six times, Sitagliptin has been found to increase the risk of pancreatic cancer by 2.7 times whereas Exenatide increases this risk by 2.9 times. The latter has also been found to increase the risk of thyroid cancer. Considering the results of the above mentioned study and the results of the previous studies on animal models, the researchers recommend thorough randomized, controlled clinical trials to assess the safety of these two drugs.

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