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GLP-1-based therapies linked to development of, hospitalization for pancreatitis among diabetes patients
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Patients with type 2 diabetes exposed to exenatide or sitagliptin were at greater risk for developing and being hospitalized for acute pancreatitis in a recent study.
Researchers evaluated data from 1,269 patients aged 18 to 64 years with type 2 diabetes and acute pancreatitis, along with 1,269 matched controls without pancreatitis. Patient information was obtained from claims data of Blue Cross Blue Shield health plans throughout seven states.
Sonal Singh
“[There are] lots of pharmaceutical studies touting the benefits of new therapies, [but] very few good studies that evaluate the harm,” researcher Sonal Singh, MD, MPH, department of medicine at Johns Hopkins University School of Medicine, told Healio.com.
Cases were grouped according to exposure to glucagonlike peptide 1 (GLP-1) therapies exenatide and sitagliptin:
- Any users: Exposed to either drug after diabetes but before pancreatitis diagnosis
- Current users: Exposed within 30 days of pancreatitis diagnosis
- Recent users: Exposed between 30 days and 2 years of pancreatitis diagnosis
- Nonusers: No exposure, or exposure 2 years or more before pancreatitis diagnosis
Patients with pancreatitis were significantly more likely than controls to report alcohol (3.23% of cases compared with 0.24%) and tobacco use (16.39% vs. 5.52%), have neoplasms (29.94% vs. 18.05%), biliary and pancreatic cancer (2.84% vs. 0%), cystic fibrosis (0.79% vs. 0%), gallstones (9.06% vs. 1.34%), obesity (19.62% vs. 9.77%) and hypertriglyceridemia (12.92% vs. 8.35%).
Use of GLP-1-based treatment was associated with acute pancreatitis risk among current (adjusted OR=2.24; 95% CI, 1.36-3.69), recent (aOR=2.01; 95% CI, 1.37-3.18) and any users (aOR=2.07; 95% CI, 1.36-3.13), after adjustment for confounders.
“Our findings suggest a significantly increased risk of hospitalization for acute pancreatitis associated with the use of sitagliptin or exenatide among adult patients with type 2 diabetes mellitus,” the researchers wrote. “Our results support findings from mechanistic studies and spontaneous reports submitted to the FDA that such an association may be causal.
“We suggest that a self-controlled case series design that allows control for individual-level confounding by disease severity may offer additional insight.”
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