期刊
DIABETES CARE
卷 36, 期 7, 页码 2126-2132出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc12-2504
关键词
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资金
- Berlin-Chemie AG/Menarini, Berlin, Germany
- Eli Lilly & Co., Indianapolis, Indiana
- Merck Sharp & Dohme, Munchen, Germany
- Novartis Pharma AG, Basel, Switzerland
- AstraZeneca, Sodertalje, Sweden
- Boehringer Ingelheim, Ingelheim, Germany
- GlaxoSmithKline, King of Prussia, Pennsylvania
- Lilly Deutschland GmbH, Bad Homburg, Germany
- MetaCure Inc., Orangeburg, New York
- Roche Pharma AG, Grenzach-Wyhlen, Germany
- Novo Nordisk Pharma GmbH, Mainz, Germany
- Amylin Pharmaceuticals, Inc., San Diego, California
- AstraZeneca, Mjolndal, Sweden
- Bristol-Myers Squibb EMEA, Rueil-Malmaison, France
- Diartis Pharmaceuticals, Inc., Redwood City, California
- F. Hoffmann-LaRoche Ltd., Basel, Switzerland
- GlaxoSmithKline LLC, King of Prussia, Pennsylvania
- Intarcia Therapeutics, Inc., Hayward, Calfornia
- MannKind Corp., Danbury, Connecticut
- Merck Sharp & Dohme GmbH, Munchen, Germany
- Merck Sharp & Dohme Corp., New Jersey
- Novo Nordisk A/S, Bagsvaerd, Denmark
- Sanofi Pharma, Bad Soden/Taunus, Germany
- Takeda, Deerfield, Illinois
- Versartis, Sunnyvale, California
- Wyeth Research, Collegeville, Pennsylvania
There is no question that incretin-based glucose-lowering medications have proven to be effective glucose-lowering agents. Glucagon-like peptide 1 (GLP-1) receptor agonists demonstrate an efficacy comparable to insulin treatment and appear to do so with significant effects to promote weight loss with minimal hypoglycemia. In addition, there are significant data with dipeptidyl peptidase 4 (DPP-4) inhibitors showing efficacy comparable to sulfonylureas but with weight neutral effects and reduced risk for hypoglycemia. However, over the recent past there have been concerns regarding the long-term consequences of using such therapies, and the issues raised are in regard to the potential of both classes to promote acute pancreatitis, to initiate histological changes suggesting chronic pancreatitis including associated preneoplastic lesions, and potentially, in the long run, pancreatic cancer. Other issues relate to an increase in thyroid cancer. There are clearly conflicting data that have been presented in preclinical studies and in epidemiologic studies. To provide an understanding of both sides of the argument, we provide a discussion of this topic as part of this two-part point-counterpoint narrative. In the point narrative preceding the counterpoint narrative below, Dr. Butler and colleagues provide their opinion and review of the data to date and that we need to reconsider use of incretin-based therapies because of the growing concern of potential risk and based on a clearer understanding of the mechanism of action. In the counterpoint narrative provided below, Dr. Nauck provides a defense of incretin-based therapies and that benefits clearly outweigh any concern of risk.
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