August 28, 2015
Dipeptidyl peptidase-4 (DPP-4) inhibitors for type 2 diabetes may cause joint pain so intense it is disabling, the US Food and Drug Administration (FDA) warned today.
Fortunately, the pain goes away, usually in less than a month, once patients stop taking the medicine.
The agency said it identified 33 cases of severe arthralgia associated with DPP-4 inhibitors from October 16, 2006, through December 31, 2013, in its FDA Adverse Event Reporting System database. Twenty-eight of the cases involved sitagliptin (Januvia, Merck & Co, Inc). Sitagliptin accounts for more than 80% of all DPP-4 prescriptions in the country, according to a spokesperson for Merck.
Patients began experiencing joint pain anywhere from 1 day to years after they started taking the drugs. For 10 patients, disabling pain required hospitalization.
Clinicians prescribe DPP-4 inhibitors in conjunction with diet and exercise to reduce blood sugar levels in patients with type 2 diabetes. They are either combined with other diabetes drugs such as metformin or dispensed as stand-alone products.