Issue 33 July 2011
7. Diabetes Medicine Updates

Diabetes Drug Dapagliflozin May Cause Bladder And Breast Cancers, Says FDA

    ¬† Bristol-Myers Squibb Co. (BMY) and AstraZeneca Plc. (AZN)'s new diabetes pill Dapaglifozin (SGLT2 inhibitor) is facing tough scrutiny as the drug is reported to raise the risk of developing breast and bladder cancers. Dapagliflozin is effective but may cause bladder and breast cancer, says the FDA as it decides whether to approve the medication. The two-year study demonstrated that when comparing those on Dapagliflozin plus metformin with a control group (just on metformin), there were 9 cases each of breast cancer and bladder cancer as compared to one case each in the control group. According to the FDA, dapagliflozin does not work so well in diabetes patients with impaired kidney function. The reviewers also mentioned liver injury, bone safety, and urinary and genital infections.

Place of pitavastatin in the statin armamentarium: promising evidence for a role in diabetes mellitus;

    ¬†Statins have revolutionized the treatment of hypercholesterolemia and coronary artery disease prevention. However, there are considerable issues regarding statin safety and further development of residual risk control, particularly for diabetic and metabolic syndrome patients.

    ¬†Pitavastatin is a potent statin with low-density lipoprotein (LDL) cholesterol-lowering effects comparable to those of atorvastatin or rosuvastatin. Pitavastatin has a high-density lipoprotein (HDL) cholesterol raising effect, may improve insulin resistance, and has little influence on glucose metabolism. Considering these factors along with its unique pharmacokinetic properties, which suggest minimal drug-drug interaction, pitavastatin could provide an alternative treatment choice, especially in patients with glucose intolerance or diabetes mellitus. Many clinical trials are now underway to test the clinical efficacy of pitavastatin in various settings and are expected to provide further information.

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