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Diabetes: too many severe adverse effects with gliptins

Gliptins have no proven efficacy in preventing diabetes complications and can cause severe, even fatal, adverse effects, including pancreatic and skin disorders. It is better to avoid these drugs.

Gliptins are commercialised as a diabetes treatment. They have no proven efficacy in preventing diabetes complications and expose patients to a range of sometimes severe adverse effects.

The findings of a French pharmacovigilance study confirm the severe adverse effects of gliptins, including pancreatic and skin disorders.

474 severe adverse effects were attributed to sitagliptin: cancers including pancreatic cancer; severe pancreatic, skin, liver and kidney disorders; musculoskeletal disorders.

456 adverse effects were attributed to vildagliptin, more than half of them severe and 9 fatal: pancreatitis, skin and kidney disorders and cancers.

The severe adverse effects attributed to saxagliptin, that has been marketed more recently, are chiefly skin and pancreatic disorders.

Overall, the harm-benefit balance of gliptins remains unfavourable.

In type 2 diabetes, when a drug treatment is necessary in addition to lifestyle and dietary measures, it is better to rule out gliptins and opt for drugs with a proven efficacy against the clinical complications of diabetes and a lower risk of adverse effects.

©Prescrire 1 May 2014

"Gliptins: severe pancreatic and cutaneous disorders" Prescrire Int 2014; 23 (149): 128. (Pdf, subscribers only)
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