FDA warns: Victoza (Liraglutide) may cause Acute Pancreatitis and Medullary Thyroid Cancer.

June 21st, 2011 by DoctorZaidi

Victoza (Liraglutide) is an antidiabetic drug which was approved by the the US Food and Drug Administration (FDA) in January 2010. Finally on June 13, 2011 FDA decided to warn healthcare professionals to closely monitor patients receiving this anti-diabetic drug for thyroid C-cell tumors and acute pancreatitis.

What is Thyroid C-cell tumor?

C-cells are special cells in the thyroid gland, which produce a special hormone called calcitonin. Cancer of these cells is called medullary thyroid cancer, a rare but one of the most malignant thyroid cancer.

What is Acute Pancreatitis?

A potentially life-threatening condition which causes acute upper abdominal pain, often accompanied with nausea and vomiting and usually radiates to the back.

Comments by Dr. Zaidi

When Victoza (liraglutide) was first approved and I saw the drug package insert warning about the potential for medullary thyroid cancer, I decided not to prescribe it to any of my patients. My guess is any endocrinologist who have dealt with medullary thyroid cancer patients would have decided along the same line.

I am glad finally FDA is warning physicians especially primary care physicians about these potential but very serious side-effects of this drugs.

It also reminds me of a very wise statement: There is not a problem till there is a problem-solver.

Actos (Pioglitazone) may increase risk of Urinary Bladder Cancer.

June 15th, 2011 by DoctorZaidi

 

FDA issued a public safety information today ( June 15, 2011) that pioglitazone ( sold under the brand name of Actos) may increase the risk of urinary bladder cancer if drug is taken more than one year and in high doses. These finding are based on the interim 5-year review of an ongoing 10-year epidemiological safety study on pioglitazone. Earlier this week, pioglitazone was taken off the market in France. And In Germany, physicians are advised not to start any new patients on pioglitazone.

In the US, the drug is on the market. Physicians are advised to be more careful about signs and symptoms of potential urinary bladder cancer such as blood in the urine, urgency of urination, low abdominal pain and pain in the low back. The continuation of the use of pioglitazone (Actos) is a decision between patients and their physicians.

Comments by Dr. Zaidi:

I think, France and Germany have over-reacted. To put things in perspective, patients with type 2 diabetes are at increased risk of any type of cancer, including urinary bladder cancer, which is a rare cancer. Why? primarily because these patients have underlying insulin resistance with compensatory high insulin level, which causes growth of tissues, benign as well as malignant.

Insulin resistance is the consequence of a number of factors including genetics, aging, obesity, sedentary lifestyle, stress and vitamin D deficiency. Therefore, my treatment approach consists of diet, exercise, atress mangement, vitamins and medications.  As far as medications are concerned, I use metformin and pioglitazone, as these are the only two drugs that treat insulin resistance: metformin treats insulin resistance at the level of liver and pioglitazone at the level of muscle and fat.

With this comprehensive approach, I have seen some amazing results in my patients: an excellent control of diabetes, with very few complications and almost no one  requiring insulin therapy.

In the last 12 years, I have treated thousands of type 2 diabetics with my above mentioned approach. Fortunately, I have not encountered a single case of urinary bladder cancer.

However, we should be careful with any drug and I agree with FDA patient safety information about pioglitazone. 

To view FDA report, please visit www.DiabetesSpecialist.com

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