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One week after the Type 2 diabetes drug Byetta was named a factor in the deaths of two patients, the drug makers have confirmed the deaths of four more people who had been taking the drug.

Byetta, made by Eli Lilly and Amylin Pharmaceuticals, has been linked to acute pancreatitis, which can result in nausea, vomiting, abdominal pain, and other symptoms. The four most recent patient deaths, revealed on August 26, 2008, were caused by a milder form of pancreatitis than the earlier deaths, officials said.

All four patients also had complicating medical conditions in addition to Type 2 diabetes, ranging from leukemia to gallstones, which were likely the primary cause of death, officials said.

The string of drug-related deaths has prompted the Food and Drug Administration to develop stronger warnings for Byetta’s labeling about the risk of pancreatitis. Byetta was approved in June 2005 and has been used by more than 700,000 people.

Byetta, a Type 2 diabetes drug made by Amylin Pharmaceuticals, Inc., has been linked to six cases of hemorrhagic or necrotizing pancreatitis. Two patients have died and four others are recovering after being hospitalized, according to the U.S. Food and Drug Administration.

The recent incidents have prompted the FDA to develop stronger, more prominent warnings for the product’s label to alert consumers about the risk of acute hemorrhagic or necrotizing pancreatitis.  Physicians are being cautioned to consider anti-diabetic therapies other than Byetta in patients with a history of pancreatitis.

The FDA warning comes less than a year after a link between Byetta and pancreatitis was first revealed by federal regulators. In October 2007, the FDA announced it had reviewed 30 cases of the condition in Byetta patients. At that time, the FDA asked Amylin Pharmaceuticals, Inc. to include information about acute pancreatitis in the precautions section of Byetta’s labeling.