Although there is little question that incretin mimetics are effective glucose-lowering agents for type 2 diabetes patients, there have been concerns raised regarding the long-term risks of such therapies, including pancreatic cancer.
What are Incretin Mimetics?
Incretin is a natural hormone made by the human body that tells the body to release insulin after you eat to lower blood sugar. Incretin mimetics act like, or mimic, the incretins in the body in the following ways:
- Prompting the pancreas to release insulin when blood sugar is rising
- Preventing the pancreas from releasing too much glucagon, a hormone that causes the liver to release stored sugar into the bloodstream
- Helping to slow the rate the stomach empties after eating
Incretin mimetics help keep blood sugar in the target range without causing low blood sugar or weight gain, and work best for people who are active and eat healthfully.
Incretin Mimetics include:
- exenatides – Byetta and Byuderon
- liraglutide – Victoza
- sitagliptin – Januvia, Janumet, Janumet XR, and Juvisync
- saxagliptin – Onglyza, Kombiglyze XR
- alogliptin – Nesina, Kazano and Oseni, and
- linagliptin – Tradjenta and Jentadueto
Incretin Mimetics and Pancreatic Cancer
One of the more serious side effects associated with incretin mimetics is pancreatic cancer. Concerns over pancreatic effects associated with incretin mimetics began following an in-depth study published March 22, 2013 in Diabetes, which documented pancreatic lesions in the pancreases of eight organ donors who took incretin mimetic therapies as compared with those taking other antidiabetic drugs.
According to the British Medical Journal, the issue of pancreatic cancer associated with incretin mimetic therapies has been downplayed by the pharmaceutical industry and regulators, including the FDA and the European Medicines Agency, have not acted as aggressively as they could.
Although both agencies launched safety reviews in 2013 and found little evidence that incretin mimetics cause pancreatic cancer, critics maintain that the drugs are risky, question the agencies’ decision-making processes, and accuse them of giving false assurances of safety. Hundreds of incretin mimetics lawsuits are currently pending in multidistrict litigation in the U.S. District Court, Southern District of California.