On Monday 10 June, Channel 4 ran a Dispatches programme looking at the track record of GLP-1 and DPP-4 drugs in the treatment of Type 2 diabetes. In particular, the programme examined research evidence available about the efficacy and side effects of the drugs in patients who have been prescribed them, and suggested that they may be linked to an increased risk of pancreatitis and pancreatic cancer.
GLP-1-based therapies are also known as incretin mimetics. These medicines act like hormones called incretins (hormones produced in the intestine) by increasing the amount of insulin released by the pancreas in response to food. DPP-4 inhibitors work by blocking the action of DPP-4, an enzyme which destroys incretins. Both drugs are authorised for use together with diet and exercise in patients with Type 2 diabetes.
The European Medicines Agency is investigating findings by a group of independent academic researchers that suggest an increased risk of pancreatitis and pancreatic cancer in patients with Type 2 diabetes treated with GLP-1 and DPP-4 drugs. The findings are based on examination of a small number of pancreatic tissue samples obtained from organ donors with and without diabetes, who died due to causes other than diabetes.
No conclusions reached
The Agency has not reached any conclusions on this investigation. There is currently no change to the recommendations on the use of these medicines and no need for patients to stop taking their medicines. Healthcare professionals are advised to continue to prescribe these medicines in accordance with the product information.
Effects on the pancreas were identified as a possible risk for these treatments during their initial trials due to the way they work, and rare cases of pancreatitis have been reported. Warnings for patients and healthcare professionals are included in the product information for all these medicines.
No change to recommendations
There is no proven link between use of GLP-1 and DPP-4 based therapies and pancreatic cancer at present, and there is currently no change to the recommendations on the use of these medicines. You should continue to take them unless advised not to do so by your doctor. If you do have any concerns about taking these treatments it is advised that you discuss it with your doctor.
Symptoms of pancreatic disease
Patients should not stop their medication, unless advised to by their doctor. Nonetheless, patients on such treatments should look out for any side effects suggestive of pancreatic disease. These symptoms may include upper abdomen pain, jaundice, weight loss, nausea, loss of appetite and fever. They should speak to their doctor immediately if they notice these symptoms.
“Patients should not stop medication unless advised”
Simon O’Neill, Diabetes UK Director of Health Intelligence, said, "The European Medicines Agency is currently investigating findings from an independent study that has suggested there may be a link between use of GLP-1 and DPP-4 based therapies for Type 2 diabetes and pancreatitis and pancreatic cancer.
"Diabetes UK does not currently advocate any change in the use of GLP-1s and DPP-4 based treatments for patients with Type 2 diabetes and will await the findings of the European Medicines Agency research. In particular, patients should not stop their medication, unless advised by their doctor."