drug adverse effects of incretin mimetics
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Adverse effects
- increased risk of pancreatitis?[1]; no[3][5]
- probably no increased risk for pancreatitis[3][4]
- increased risk of pancreatitis when used for weight loss[15]
- increased risk for pancreatic duct metaplasia?[2]; no[3]
- no increased risk of pancreatic cancer[5]
- no increased risk for pancreatic disease[3]
- delayed gastric emptying, gastroparesis*[14]
- increased risk of gastroparesis when used for weight loss[15]
- increased risk of bowel obstruction when used for weight loss[15]
- not associated with increased risk for hospitalization due to heart failure[6]
- cases of postmarketing acute cholecystitis with GLP-1 mimetics[12]
- increased risk of gallbladder disease & disorder of the bile ducts[7]
- may increase risk for cholangiocarcinoma[10]
- increased risk of gallbladder or biliary diseases, especially when used at higher doses, for longer durations, & for weight loss[11]
- no increased risk for breast cancer[8]
- increased risk of overall thyroid cancer (RR=1.52) but not papillary thyroid cancer or medullary thyroid cancer[16]
- no increased risk of mortality[9]
- alopecia, pulmonary aspiration, suicidal ideation (potential)[17]
- FDA clears GLP-1 receptor agonists of suicidal risk, but continues review[17]
* Black box warning of contraindication for personal of family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia-2 (MEN2) (based on rodent studies where GLP-1 receptors on parfollicular cells induced C-cell proliferation & develpment of C-sell tumors)[13]
* prone to retained gastric contents on upper GI endoscopy[14]
More general terms
References
- ↑ 1.0 1.1 Singh S et al Glucagonlike Peptide 1-Based Therapies and Risk of Hospitalization for Acute Pancreatitis in Type 2 Diabetes Mellitus. A Population-Based Matched Case-Control Study. JAMA Intern Med. 2013;():1-6. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23440284 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=1656537
- ↑ 2.0 2.1 FDA Drug Safety Communication: FDA investigating reports of possible increased risk of pancreatitis and pre-cancerous findings of the pancreas from incretin mimetic drugs for type 2 diabetes. http://www.fda.gov/Drugs/DrugSafety/ucm343187.htm
- ↑ 3.0 3.1 3.2 3.3 3.4 Egan AG et al Pancreatic Safety of Incretin-Based Drugs - FDA and EMA Assessment. N Engl J Med 2014; 370:794-797February 27, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24571751 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMp1314078
- ↑ 4.0 4.1 Li L et al. Incretin treatment and risk of pancreatitis in patients with type 2 diabetes mellitus: Systematic review and meta-analysis of randomised and non-randomised studies. BMJ 2014 Apr 15; 348:g2366. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24736555
Faillie JL et al. Incretin based drugs and risk of acute pancreatitis in patients with type 2 diabetes: Cohort study. BMJ 2014 Apr 24; 348:g2780 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24764569 - ↑ 5.0 5.1 5.2 Azoulay L et al Incretin based drugs and the risk of pancreatic cancer: international multicentre cohort study. BMJ 2016;352:i581 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26888382 Free Article <Internet> http://www.bmj.com/content/352/bmj.i581
Bolen SD, Maruthur NM The safety of incretin based drug treatments for type 2 diabetes. BMJ 2016;352:i801 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26888024 <Internet> http://www.bmj.com/content/352/bmj.i801 - ↑ 6.0 6.1 Filion KB, Azoulay L, Platt RW et al A Multicenter Observational Study of Incretin-based Drugs and Heart Failure. N Engl J Med 2016; 374:1145-1154. March 24, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27007958 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1506115
- ↑ 7.0 7.1 Faillie JL, Yu OH, Yin H et al Association of Bile Duct and Gallbladder Diseases With the Use of Incretin-Based Drugs in Patients With Type 2 Diabetes Mellitus. JAMA Intern Med. Published online August 01, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27478902 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=2540538
Butler PC Glucagon-Like Peptide 1 Drugs as Second-Line Therapy for Type 2 Diabetes.' JAMA Intern Med. Published online August 01, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27479247 <Internet> http://archinte.jamanetwork.com/article.aspx?articleid=2540531 - ↑ 8.0 8.1 Hicks BM, Yin H, Yu OH et al Glucagon-like peptide-1 analogues and risk of breast cancer in women with type 2 diabetes: population based cohort study using the UK Clinical Practice Research Datalink. BMJ 2016;355:i5340 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27797785 Free Article <Internet> http://www.bmj.com/content/355/bmj.i5340
Bolen SD, Maruthur NM Glucagon-like peptide-1 receptor agonists and risk of breast cancer. BMJ 2016;355:i5519 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27797789 <Internet> http://www.bmj.com/content/355/bmj.i5519 - ↑ 9.0 9.1 Liu J, Li L, Deng K et al Incretin based treatments and mortality in patients with type 2 diabetes: systematic review and meta-analysis. BMJ. 2017 Jun 8;357:j2499. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28596247 Free PMC Article
- ↑ 10.0 10.1 Abrahami D, Douros A, Yin H et al Incretin based drugs and risk of cholangiocarcinoma among patients with type 2 diabetes: population based cohort study. BMJ 2018;363:k4880 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30518618 https://www.bmj.com/content/363/bmj.k4880
- ↑ 11.0 11.1 He L, Wanf J, Ping F et al Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases. A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Intern Med. Published online March 28, 2022 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35344001 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2790392
Halder S, Lipska KJ Glucagon-Like Peptide-1 Receptor Agonists - How Safe Are They? JAMA Intern Med. Published online March 28, 2022 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35344015 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2790398 - ↑ 12.0 12.1 Woronow D, Chamberlain C, Niak A et al Acute Cholecystitis Associated With the Use of Glucagon-Like Peptide-1 Receptor Agonists Reported to the US Food and Drug Administration. JAMA Intern Med. Published online August 29, 2022 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36036939 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2795476
- ↑ 13.0 13.1 NEJM Knowledge+ Endocrinology
- ↑ 14.0 14.1 14.2 Kobori T et al. Association of glucagon-like peptide-1 receptor agonist treatment with gastric residue in an esophagogastroduodenoscopy. J Diabetes Investig 2023 Jun; 14:767. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36919944 PMCID: PMC10204182 Free PMC article https://onlinelibrary.wiley.com/doi/10.1111/jdi.14005
- ↑ 15.0 15.1 15.2 15.3 Sodhi M, Rezaeianzadeh R, Kezouh A et al Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss. JAMA. Published online October 5, 2023 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37796527 https://jamanetwork.com/journals/jama/fullarticle/2810542
- ↑ 16.0 16.1 Silverii GA, Monami M, Gallo M et al Glucagon-like peptide-1 receptor agonists and risk of thyroid cancer: A systematic review and meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2023 Nov 29. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38018310
- ↑ 17.0 17.1 17.2 O'Mary L FDA Evaluating Three Side Effects Reported With Weight Loss Drugs. Medscape. January 05, 2024 https://www.medscape.com/s/viewarticle/fda-investigates-three-side-effects-reported-weight-loss-2024a10000e4
Monaco K FDA Clears Wegovy, Other GLP-1 Drugs of Suicidality Risk for Now. Preliminary evaluation reassures, while the agency's review continues. MedPage Today January 11, 2024 https://www.medpagetoday.com/primarycare/obesity/108223