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Liraglutide lowers pancreatitis risk in type 2 diabetes
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Adults with type 2 diabetes at high cardiovascular risk have a lower risk for pancreatitis when treated with liraglutide compared with placebo, according to findings published in Diabetes Care.
William M. Steinberg, MD, clinical professor of medicine at George Washington University Medical Center, and colleagues evaluated data from the LEADER trial on 9,340 adults (mean age, 64.3 years; 64.3% men) with type 2 diabetes (mean diabetes duration, 12.9 years) and high CV risk randomly assigned to liraglutide (Victoza, Novo Nordisk; n = 4,668; median daily dose, 1.78 mg) or placebo (n = 4,672) for a median observation time of 3.84 years. Researchers sought to determine serum amylase and lipase levels and the rate of acute pancreatitis. Overall, 267 participants had a history of pancreatitis (147 in the liraglutide group; 120 in the placebo group).
There was an estimated relative 28% increase in lipase associated with liraglutide at 36 months (P < .001) with an observed lipase change from 40 U/L to 55.2 U/L, and there was an estimated 7% increase in amylase (P < .001) with an observed amylase change from 59.4 U/L to 70.9 U/L.
More participants in the liraglutide group experienced at least one elevated lipase level over time (51.3%) compared with the placebo group (31.8%). Similarly, more participants in the liraglutide group experienced at least one elevated amylase level over time (29%) compared with the placebo group (22.9%).
Eighteen participants in the liraglutide group (1.1 per 1,000 person-years of observation) and 23 in the placebo group (1.7 per 1,000 person-years of observation) had a confirmed acute pancreatitis event. Acute pancreatitis mostly occurred more than 12 months after the beginning of the trial. Acute pancreatitis recurred in two participants in the liraglutide group and six participants in the placebo group with a previous history of pancreatitis.
“This study confirmed and extended observations concerning the effect of liraglutide on the pancreas,” the researchers wrote. “In LEADER, numerically fewer events of acute pancreatitis were observed in liraglutide-treated patients compared with the placebo group. Liraglutide increased serum amylase, and especially lipase, and this increase plateaued and remained stable for the duration of the study. Liraglutide-induced elevations of lipase and amylase in asymptomatic patients were not predictive of the development of acute pancreatitis.” – by Amber Cox
Disclosure: The study was funded in part by Novo Nordisk. Steinberg reports various financial ties with Amylin, Eli Lilly and Company and Novo Nordisk. Please see the full study for a list of all other authors’ relevant financial disclosures.
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