Never Be The First To Prescribe And Never Be The Last Part 2

About a year & half ago, I commented on a study looking at the risk of pancreatitis when using a new class of diabetes medications.  Due to cost issues, I really hadn't had a chance to prescribe these new medications, instead sticking with inexpensive generics.  But then a patient came in earlier this week asking about the plethora of billboards popping up all over town warning about the risk of pancreatitis & pancreatic cancer after taking these medications and suggesting that any one who's ever taken one call the attorneys immediately.

So I gave him my lottery analogy.  Which is to say, many people toss a few dollars into the lottery hoping to win but just about no one does.  However, for that one lucky person, winning the lottery will change his/her life.  Likewise, many people take these medications hoping that they won't develop pancreatitis or pancreatic cancer.  However, for that one unlucky person, getting either condition will change his/her life.

So of course I'm a day late & a dollar short.  I just stumbled upon a population-based case-control study published early online this week in JAMA Internal Medicine in which the authors concluded that glucagon-like peptide 1 therapies are linked to increase risk for pancreatitis.

To arrive at their conclusion, the authors found 1,269 cases in which the patient was hospitalized for pancreatitis.  Then they found 1,269 controls matched for age, gender & diabetes complications.  Avg age was 52yo w/men accounting for just over half the group.  When the cases were compared to the controls, they were noted to have high triglycerides, alcohol use, gall stones, tobacco use, obesity, biliary & pancreatic cancer, cystic fibrosis and any cancer.  Of note, both GLP-1 mimetics and dipeptidyl peptidase 4 inhibitors were linked to increase risk of pancreatitis.

I guess that means I'm going to have to hunt down this patient and have another discussion regarding this study.  But of course, neither insurance nor Medicare/Medicaid will pay for the phone call to review this study in order to assist him in making the right choice for him.

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