https://diabetes.acponline.org/archives/2016/08/12/2.htm

Incretin-based drugs not associated with higher risk of pancreatitis in large, population-based study

The findings of this study should provide some reassurance to patients treated with incretin-based drugs, according to the authors.


Use of incretin-based drugs was not associated with an increased risk of acute pancreatitis compared with 2 or more other oral antidiabetic drugs in patients with type 2 diabetes, a population-based study concluded.

Researchers conducted a large, international, multicenter, population-based cohort study using combined health records from 7 sites in Canada, the United States, and the United Kingdom for more than 1.5 million people with type 2 diabetes who started using antidiabetic drugs between January 2007 and June 2013, with follow-up through June 2014.

Nested case-control analyses were conducted in which hospitalized patients with acute pancreatitis were matched with up to 20 control subjects by sex, age, cohort entry date, duration of treated diabetes, and follow-up duration. Secondary analyses were performed to assess whether the risk of pancreatitis varied by class of drug or duration of use. Results were published online Aug. 1 by JAMA Internal Medicine.

During nearly 3.5 million person-years of follow-up, 5,165 patients were hospitalized for acute pancreatitis (incidence rate, 1.49 per 1,000 person-years). Compared with current use of 2 or more oral antidiabetic drugs, current use of incretin-based drugs was not associated with an increased risk of acute pancreatitis (pooled adjusted hazard ratio [HR], 1.03; 95% CI, 0.87 to 1.22). Risk did not vary by drug class (dipeptidyl peptidase-4 inhibitors: pooled adjusted HR, 1.09 [95% CI, 0.86 to 1.22]; glucagon-like peptide 1 agonists: pooled adjusted HR, 1.04 [95% CI, 0.81 to 1.35]) and there was no evidence of a duration-response association. Finally, there was no evidence of effect modification by history of acute or chronic pancreatitis (no history: pooled adjusted HR, 1.05 [95% CI, 0.86 to 1.27]; history: pooled adjusted HR, 0.70 [95% CI, 0.42 to 1.17]; P=0.20 for interaction);

“Although it remains possible that these drugs may be associated with acute pancreatitis, the upper limit of our 95% CI suggests that this risk is likely to be small,” the authors wrote. “Thus, the findings of this study should provide some reassurance to patients treated with incretin-based drugs.”