Deaths stalk GLP-1 agonist

The type 2 diabetes drug Byetta (exenatide) has been linked to the deaths of six people with acute nectrotizing or hemorrhagic pancreatitis, prompting the US Food and Drug Administration to call for stronger label warnings. Amylin, of San Diego, and Eli Lilly, of Indianapolis, which co-market the drug, admit the association between Byetta usage and acute pancreatitis is possible, although it is unclear what role glucagon-like peptide 1 (GLP-1) agonists played in causing the fatal symptoms. Individuals with diabetes are normally three times more likely to develop the condition than nondiabetics, partly because conventional treatments for type-2 diabetes are also associated with pancreatitis. Daniel Drucker, director of Banting and Best Diabetes Centre at the University of Toronto says more pancreatitis data across different classes of antidiabetic drugs are needed to “determine whether the disease is more or less commonly seen with Byetta versus other antidiabetic agents.” Byetta is a synthetic peptide with 53% homology to human GLP-1. It is the first in a new class of drugs called GLP-1 agonists, which mimic the hormone's ability to induce insulin secretion and downregulate blood glucose levels after eating. Drucker, who consults for GLP-1 agonist producers, including Amylin, acknowledges that clinicians are “somewhat apprehensive about GLP-1 therapies,” but expects opinions to change once clinical data emerge over the next year. Byetta's main competitor is Liraglutide, a long-acting human GLP-1 agonist produced by Novo Nordisk, of Copenhagen, which could be approved by mid-2009.


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Hyer, J. Deaths stalk GLP-1 agonist. Nat Biotechnol 26, 1204 (2008).

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