In the midst of the recent allegations of heart failure surrounding the popular type-2 diabetes drug, Onglyza, a recent study suggests that these concerns may not be misplaced. A researcher from Louisiana State University is advising doctors to be wary of what diabetes medications they prescribe, discussing her concerns at this year’s annual meeting of the American Association of Diabetes Educators.

Emily Wieldman-Evans, a clinical associate professor at LSU’s Health Science Center, indicated that it was difficult to determine which diabetes medications could cause heart failure, rather than reduce the risk of cardiac complications. Wieldman-Evans discussed several major diabetes medications like those belonging to the DPP-4 inhibitor group.

She states that since the blockbuster diabetes treatment drug, Avandia, had been linked to heart failure in 2007, the FDA has become suspicious of other major popular diabetes medications. At the time, several studies had indicated that as many as 100,000 heart attacks could have been linked to Avandia, spurring the FDA to require the drug’s label to be updated and include stronger warnings of heart failure.

Wieldman-Evans and other experts at the conference believe that if stronger warnings of heart failure were attached to the popular diabetes medications mentioned above, there could be far less heart attacks.

Onglyza Heart Failure

One of the drugs at the center of the diabetes medication controversy is Onglyza, a DPP-4 inhibitor that works by copying incretin hormones in the patient’s body, which is produced to naturally stimulate insulin release to breakdown food. It is important to note that Onglyza and other diabetes medications mentioned are meant for type-2 diabetes patients specifically, as each of them need insulin to work.

Type-2 diabetes is caused by an extreme blood sugar glucose imbalance, which can be triggered by gaining weight and eating an excessive amount of sugar. This condition effects millions of Americans in the country and is considered one of the major health crises of the 21st century. The large number of diabetic patients had incited many large pharmaceutical companies to produce diabetes medications, as it is a lucrative target market.

Onglyza is marketed and developed by AstraZeneca, and had garnered over $700 million in sales in 2012. While it still remains a widely-prescribed diabetes medication, it has also been at the center of heart failure allegations by medical experts and warnings alike. In April 2015, the FDA’s Endrocrinologic and Metabolic Drugs Advisory Committee had voted 14-1 in recommending stronger warnings of potential heart failure to Onglyza’s warning label.

The agency conducted this vote in response to clinical data their members reviewed, which indicated that Onglyza users could face a higher risk of cardiac complications and possible fatalities.

Furthermore, it has been noted that pharmacy benefits manager, Express Scripts, announced that it would no longer provide coverage for Onglyza due to this potential side effect. Express Scripts provides drug insurance coverage to approximately 25 million patients in America and recommends Januvia as a safer alternative.

Other medical experts are inclined to agree, as several studies have suggested that Onglyza heart failure could be specific to the drug, and not a problem with the entire drug class.

A study published in the New England Journal of Medicine on June 08, 2015, had analyzed the side effects of Onglyza, Januvia and other type-2 diabetes medications. It found that while Januvia did not increase the risk of heart failure, Onglyza had significantly increased the risk of heart disease.

Overall, Wieldman-Evans states that doctors should prescribe diabetes medications on a case-by-case with patients, determining what side effects the patient may be vulnerable to.