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Are Newer Diabetes Drugs More Effective? Study Suggests Not

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When type 2 diabetes drug Onglyza first came on the market in 2009, manufacturers advertised it as superior to other similar medications. According to a recent study, however, as far as their long-term efficacy and how much these drugs protect patients’ overall health, there isn’t much of a difference between diabetes drugs.

The study was published in the Journal of the American Medical Association (JAMA) on July 19, 2016.

Study Finds No Significant Differences Between Diabetes Drugs

Researchers examined data from a total of 301 clinical trials involving over 110,000 patients. Most of the studies involved diabetes drugs given alone to treat type 2 diabetes, but there were also over 100 that involved adding other drugs to the standard treatment with metformin (dual therapy), while 29 involved drugs added to both metformin and sulfonylurea (triple therapy).

Drugs in this study included Onglyza, Actos, Januvia, metformin, Glyset, and sulfonylureas. These were further divided into classes: thiazolidinediones (Actos, Avandia), DPP-4 inhibitors (Onglyza and Januvia), and glucosidase inhibitors (Precose and Glyset).

Results showed the following:

  •  There were no significant differences between any of the drugs in terms of risk of death from cardiovascular disease or from any other cause.
  • Metformin was associated with lower or no significant difference in A1C levels (a marker of blood glucose levels) than any of the other drugs.
  • All drugs were found to be effective when added to metformin.

 Second Study Confirms Metformin as First-Line Therapy

The findings are interesting as the manufacturers of Onglyza and other type 2 diabetes medications have advertised their drugs as superior to others. Yet, in this study, metformin was found to be the most reliable initial treatment, which is a similar result to what was reported in an earlier study this year.

In April 2016, researchers reported that metformin was the best first-line therapy for type 2 diabetes in the Annals of Internal Medicine. After comparing the effectiveness and safety of several different types of drugs across 179 trials and 25 observational studies, they found the following:

  • Cardiovascular mortality was lower for patients using metformin versus sulfonylureas.
  • Reductions in A1C levels were similar across all monotherapies (when one drug is used) and metformin-based combinations (metformin combined with another drug), except that DPP-4 inhibitors like Onglyza had smaller effects.
  • Patients were able to reduce or maintain their body weight while using metformin and most other drugs, though it increased with sulfonylureas, thiazolidinediones, and insulin.
  • Hypoglycemia was more frequent with sulfonylurea use.
  • Gastrointestinal problems were highest with use of metformin and GLP-1 receptor agonists.

Researchers concluded that “evidence supports metformin as first-line therapy for type 2 diabetes, given its relative safety and beneficial effects on hemoglobin A1C, weight, and cardiovascular mortality.”

New Diabetes Drugs Linked with Serious Risks

These studies raise questions new drug advertising that test the product as superior to older ones before the drug manufacturer has all the information needed to make such a conclusion. Meanwhile, newer drugs like Onglyza have been linked with potentially serious side effects, like an increased risk of heart failure.

A number of plaintiffs who have suffered such side effects from their use of a diabetes drug are now seeking compensation in court. The manufacturers of Januvia, for example, are currently defending lawsuits around the country that claim they provided inadequate warnings about the risks. The FDA recently required Onglyza manufacturers, as well, to add new warnings to the product label, indicating that it may increase risks of heart problems.