New drug for diabetes safe so far

Dear Dr. Roach: Please give me your opinion on the drug Rybelsus. It is advertised on TV as a wonder drug to reduce the A1C count for diabetics. My only problem with taking Rybelsus is that, in the package insert, it says in studies with rodents, it caused thyroid tumors, but it is not known if Rybelsus will cause thyroid tumors or thyroid cancer in people. This makes me feel like I am a test animal.

G.L.

Answer:

Semaglutide (Rybelsus, Ozempic and Wegovy) is a newer medication for Type 2 diabetes. The safety and efficacy data are promising. It is effective at lowering blood sugar and improves the risk of heart disease and overall mortality.

The issue with thyroid cancer is not clear, but large studies done so far with this class of drugs in primate animals and in humans have shown no increase in the risk of thyroid cancer.

The FDA always tries to balance risks and benefits. New medicines that show promise are often approved on the condition that the risks are both communicated to patients and studied after the drug is marketed.

Dear Dr. Roach: Iam a 79-year-old physician who had a positive tuberculosis test during medical school in the late ‘60s. I was started on two anti-tuberculin medications, which I took for nine months without difficulty. If I had a T-SPOT blood test now, would it still be positive? Is there any way to know if I have latent TB?

Answer: Latent tuberculosis is when a person has been infected by tuberculosis bacteria, but the body is keeping the infection from becoming active. Most people are recommended to have treatment to reduce the lifetime risk of developing active TB.

Unfortunately, both the skin test and the interferon tests are usually positive even after prolonged treatment. There is no way to know whether every tuberculosis bacteria has been killed. Fortunately, your lifetime risk for developing active tuberculosis is only about 1% after treatment.