Over the relatively short time since their launch, the use of DPP 4 inhibitors has accelerated to the point that they are widely used in the treatment of Type 2 diabetes, often being used early in the treatment pathway. This is despite the lack of significant evidence about their cardiovascular impact and the fact that the diabetes world has only just digested the impact of the Rosiglitazone debacle. This lead to new FDA guidelines regarding the development of new drugs for diabetes and their being subjected to CV risk studies.

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The massive debate over links between the use of incretin drugs (DPP-4 inhibitors and GLP-1RA injectables) and pancreas safety has, to this point, been based on anecdote, controversial science and retrospective cohort analyses. These are all prone to various forms of bias leading, in my view, to the correct analysis and advice from the Federal Drugs Administration, European Medicines Agency (and any other legitimate body that has issued comment) to continue current prescribing.

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