Connect
MJA
MJA

Safety of incretin-based therapies for type 2 diabetes

Timothy M E Davis
Med J Aust 2011; 195 (6): . || doi: 10.5694/mja11.10648
Published online: 19 September 2011

Australian database linkages could be used for postmarketing surveillance of antidiabetic therapy side effects

Several incretin hormone-based therapies for type 2 diabetes are marketed in Australia. These are exenatide (the glucagon-like peptide-1 [GLP-1] analogue) and sitagliptin, vildagliptin and saxagliptin (inhibitors of the enzyme dipeptidyl-peptidase-4 [DPP-4]). These drugs are attractive because they improve blood glucose control without weight gain and with less hypoglycaemia than insulin and its secretagogues. Their distinct mode of action means that they improve glycaemic control when added to more established blood glucose-lowering therapies. This underlies their current Pharmaceutical Benefits Scheme listing as part of dual or, in the case of exenatide, triple therapy with metformin and/or sulfonylurea treatment.


  • University of Western Australia, Fremantle, WA.


Correspondence: tdavis@cyllene.uwa.edu.au

Acknowledgements: 

I am supported by a Practitioner Fellowship from the National Health and Medical Research Council.

Competing interests:

I have served on advisory boards for Merck Sharp and Dohme (MSD), Novartis and Bristol-Myers Squibb (BMS), companies which market DPP-4 inhibitors in Australia, and Novo Nordisk, which manufactures liraglutide. I have had attendance costs for sacientific meetings covered by MSD and Novartis, and have received lecture fees from MSD, Novartis, BMS and Novo Nordisk.

  • 1. Denker PS, Dimarco PE. Exenatide (exendin-4)-induced pancreatitis: a case report. Diabetes Care 2006; 29: 471.
  • 2. Nauck MA. Incretin-based therapies for type 2 diabetes mellitus: properties, functions, and clinical implications. Am J Med 2011; 124 (1 Suppl): S3-S18.
  • 3. Willemen MJ, Mantel-Teeuwisse AK, Straus SM, et al. Use of dipeptidyl peptidase-4 inhibitors and the reporting of infections: a disproportionality analysis in the World Health Organization VigiBase. Diabetes Care 2011; 34: 369-374.
  • 4. Hawkes N. Journal withdraws article after complaints from drug manufacturers. BMJ 2011; 342: d2335.
  • 5. Elashoff M, Matveyenko AV, Gier B, et al. Pancreatitis, pancreatic and thyroid cancer with glucagon-like peptide-1-based therapies. Gastroenterology 2011; 141: 150-156.
  • 6. Hartnell NR, Wilson JP. Replication of the Weber effect using postmarketing adverse event reports voluntarily submitted to the United States Food and Drug Administration. Pharmacotherapy 2004; 24: 743-749.
  • 7. Hochberg AM, Reisinger SJ, Pearson RK, et al. Using data mining to predict safety actions from FDA adverse event reporting system data. Drug Information J 2007; 41: 633-643.
  • 8. Garg R, Chen W, Pendergrass M. Acute pancreatitis in type 2 diabetes treated with exenatide or sitagliptin: a retrospective observational pharmacy claims analysis. Diabetes Care 2010; 33: 2349-2354.
  • 9. Gale EA. Insulin glargine and cancer: another side to the story? Lancet 2009; 374: 521.
  • 10. Piccinni C, Motola D, Marchesini G, Poluzzi E. Assessing the association of pioglitazone use and bladder cancer through drug adverse event reporting. Diabetes Care 2011; 34: 1369-1371.

Author

remove_circle_outline Delete Author
add_circle_outline Add Author

Comment
Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.