Use of incretin agents and risk of acute and chronic pancreatitis: A population‐based cohort study. Issue 3 (7th February 2017)

• Record Type: Journal Article
• Authors: Knapen, Lotte M.; de Jong, Roy G. P. J.; Driessen, Johanna H. M.; Keulemans, Yolande C.; van Erp, Nielka P.; De Bruin, Marie L.; Leufkens, Hubert G. M.; Croes, Sander; de Vries, Frank
• Is Part Of: Diabetes, obesity & metabolism. Volume 19:Issue 3(2017)
• Page Start: 401
• Page End: 411
• Publication Date: 2017-02-07
• Subjects: acute pancreatitis -- chronic pancreatitis -- cohort studies -- dipeptidyl peptidase‐4 inhibitors -- glucagon‐like peptide‐1 receptor agonists -- incretin‐based therapy -- type 2 diabetes mellitus; Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.12833
• Languages: English
• ISSNs: 1462-8902

Abstract

Abstract : Aim: To determine the association between the use of incretin agents (dipeptidyl peptidase‐4 inhibitors and glucagon‐like peptide‐1 receptor agonists) for the treatment of type 2 diabetes mellitus (T2DM) and the risk of any, acute and chronic pancreatitis. Research design and methods: A population‐based cohort study was conducted using data from the UK Clinical Practice Research Datalink (CPRD 2007–2012). A total of 182 428 adult patients with ≥1 non‐insulin antidiabetic drug (NIAD) prescription were matched to control subjects without diabetes. Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of pancreatitis in incretin‐users (N = 28 370) compared with controls and with other NIAD users. Adjustments were made for lifestyle, disease and drug history. In a sensitivity analysis, a new‐user design was used. Results: Current incretin users had a 1.5‐fold increased risk of any pancreatitis compared with NIAD users (adjusted HR 1.47, 95% CI 1.06–2.04). In incident current incretin users the risk of any and acute pancreatitis was increased 2.1‐ and 2.0‐fold compared with NIAD users (adjusted HR 2.12, 95% CI 1.31–3.43 and adjusted HR 1.96, 95% CI 1.13–3.41), whereas there was no increased risk found for chronic pancreatitis. Conclusions: Incretin use was associated with an increased risk of any pancreatitis. Moreover, risk of any and acute pancreatitis was higher when applying a new‐user design. We were not able to detect an association with chronic pancreatitis, but the number in this subgroup was small.