Saturday, 7 November 2009

Diabetes drug Byetta tied to kidney problems, says FDA

STORY HIGHLIGHTS (published on November 4th at 5 pm)

· People with type 2 diabetes taking drug Byetta may be at risk for kidney problems

· Byetta was linked to higher risk of acute pancreatitis, which is potentially life-threatening

· Kidney symptoms can include changes in urine color, swelling in feet and legs, fatigue, nausea

People with type 2 diabetes who are taking the blood-sugar-lowering drug Byetta may be at increased risk for kidney problems, including kidney failure, the U.S. Food and Drug Administration reported this week.

The drug's label will be updated to warn doctors and patients about this possible side effect.

Byetta (exenatide) is a relatively new drug and was approved to treat type 2 diabetes in 2005. It's known as an incretin mimetic and is a synthetic version of a compound found in the venom of a Gila monster, a lizard in the southwestern United States.

Doctors wrote almost 7 million Byetta prescriptions between 2005 and 2008. The drug is injected, and patients and doctors tend to like it because it's easier to inject than insulin and can promote weight loss in some people.

When Exenatide (Byetta) came out, there was a rush to prescribe it among the Family Practitioners (the effect of Drug Reps?), as you can see nearly 2 million prescriptions per year! How many of us know the cost of Byetta for one month?

Walgreen's: $182.50
CVS Pharmacy: $226.99
Kroger (supermarket) pharmacy: $163.95
Publix (supermarket) pharmacy: $196.96

In the clinics for the Indians where I work, I have not started a single patient on Byetta. There is just one patient under my care who was prescribed Byetta by someone else and he is fighting the workers compensation board regarding some injury so I have not changed his medications.

I am very reluctant to jump into the bandwagon about prescribing new medications since in my field of Endocrinology, new medications come and very quickly are shown to have serious side effects and we always fall back on the time and proven medications. Glyburide/Metformin/Non Modified Insulins were the only medications on the market few years ago and the major increase in expenses for Diabetes Care in America is due to the increase in the price of newer medications. The newer insulins are three to four times as expensive as the older ones. I would like to hear how much improvement in “numbers” these newer insulins have made on a community wide basis..

It is well accepted that the kidney metabolism of American Indians along with many other indigenous peoples of the world is very delicate and very prone to damage. So it is another reason not to prescribe Exanetide to Indian patients..