An observational study published in the journal JACC Heart Failure raises alarming questions about the type 2 diabetes drug Januvia (sitagliptin) and heart failure.
The study involved an analysis of insurance claims from a database of more than 7,600 patients with diabetes and heart failure. Researchers found that people who took Januvia were just as likely as people who did not use Januvia to die or be hospitalized for any reason. However, patients using the drug were more likely to be hospitalized for heart failure.
Researchers say the results could impact whether Januvia is prescribed as an add-on therapy for heart failure patients with diabetes. Deepak Bhatt wrote that the study adds “to a small but growing body of evidence that suggests DPP-4 inhibitors as a class of drugs, and possibly diabetes drugs in general, may increase the risk of heart failure.”
In 2010, the Food and Drug Administration (FDA) severely restricted the use of the type 2 diabetes drug Avandia after it was linked to fatal heart attacks. The agency has since requested that drug companies testing newer diabetes treatments conduct studies on cardiovascular adverse events.
However, more concerns have been raised about cancer risks with newer diabetes drugs. Avandia and the diabetes drug Actos are in a class of diabetes drugs known as thiazolidinediones. While researchers have looked into heart risks with Actos, the most alarming side effect to emerge in studies was bladder cancer.
Januvia is in a newer subclass of diabetes drugs known as dipeptidyl peptidase (DPP)-4 inhibitors, which make up a larger class of diabetes medications known as incretin mimetics. This class also includes the drug Byetta. Recent research has linked both Januvia and Byetta – as well as other incretin mimetics – to a painful inflammation of the pancreas known as acute pancreatitis. The drugs have also been linked to pancreatic cancer.