Invokana, a diabetes drug made by Johnson & Johnson, decreases the risk of heart attacks and strokes, but also increases the risk of amputation, particularly of toes.
The result is a blow to J&J, and a boost to rivals Eli Lilly and Boehringer Ingelheim, who make a similar drug called Jardiance, which has been shown to reduce the risk of cardiovascular death but does not appear to carry the amputation risk.
The study also deepens the mystery about such drugs, known as sodium-glucose co-transporter 2 (SGLT2) inhibitors, which prevent the kidney from absorbing sugar from the blood. This lowers blood sugar, is good for the kidney, but leads to more urinary tract infections and weakened bones. But scientists are not sure why the drugs would prevent cardiovascular disease, and it’s entirely unclear why one of them would lead to amputations. “It justifies the need to test each medicine,” says Harlan Krumholz, of Yale University.
For every three heart attacks, strokes, or cardiovascular deaths prevented by Invokana, there were two amputations, 71% of them of toes or the lower foot, according to the results of the 10,142-patient study, which was funded by Johnson & Johnson. It is being presented at the annual meeting of the American Diabetes Association tonight, and published by the New England Journal of Medicine.
Heart attacks were far more common than amputations. For every year patients took the drug, there were 31.5 heart attacks, strokes, or cardiovascular deaths per 1,000 patients in the placebo group and 26.9 in the group that took Invokana, a 14% decrease…
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