Januvia- 1st line now for DM

The Wall Street Journal (10/18, D6, Rubenstein) reports that the FDA approved Merck & Co.'s request to expand their diabetes drug Januvia (sitagliptin) "to be used as initial therapy along with a popular diabetes drug called metformin, as an add-on for patients who have tried a type of drug called a sulfonylurea, and as an add-on to a combination of both a sulfonylurea and metformin." However, "the company also added information to the drug's label about reports of serious allergic reactions among some who have taken it."

One of "the illnesses reported by Januvia users was a sometimes fatal skin ailment called Stevens-Johnson syndrome." But the company said that no conclusion could be drawn about whether the drug was the cause because "there wasn't enough data." Merck also noted that "some patients...suffered anaphylaxis, a severe whole-body allergic reaction that can cause a person to go into shock, and angioedema, a swelling of the skin that leads to welts."