Incretin-based glucose-lowering medications and the risk of acute pancreatitis and malignancies
- Some epidemiological data have suggested an elevated risk of acute pancreatitis and pancreatic cancer after exposure to glucagon-like peptide (GLP)-1 receptor agonists and dipeptidyl peptidase (DPP)-4 inhibitors. Recently, such outcomes have been assessed and adjudicated as adverse events of special interest in cardiovascular outcomes studies. We performed a meta-analysis of cases of acute pancreatitis and pancreatic cancer as well as any malignant neoplasm reported in cardiovascular outcomes trials (CVOTs) with GLP-1 receptor agonists and DPP-4 inhibitors. The numbers of cases observed with active drug or placebo (both on a background of standard care) were related to patient-years of observation. Rate ratios and their confidence intervals were calculated for the individual agents as well as for the classes of GLP-1 receptor agonists and DPP-4 inhibitors. Neither data on individual CVOTs of GLP-1 receptor agonists nor their meta-analysis [rate ratio: 1.05 (0.78–1.41)] indicated a significantly elevated risk of acute pancreatitis. All individual DPP-4 inhibitors displayed a non-significant trend towards an increased risk of acute pancreatitis, which was significant in the meta-analysis [1.75 (1.14–2.70); \(\it P\) = 0.01]. Neither GLP-1 receptor agonists nor DPP-4 inhibitors were associated with a significantly elevated or reduced risk of pancreatic cancer or for the totality of all malignant neoplasms. Based on a large database of randomized, placebo-controlled, prospective cardiovascular outcomes studies with GLP-1 receptor agonists and DPP-4 inhibitors, no signal for pancreatic cancer or any malignant neoplasms were detected. However, a 75% risk increase for the development of an acute pancreatitis was seen in the meta-analysis of DPP-4 inhibitor CVOTs.
Author: | Mirna Safia Abd El AzizGND, Oscar CahyadiGND, Juris MeierORCiDGND, Wolfgang E. SchmidtGND, Michael NauckORCiDGND |
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URN: | urn:nbn:de:hbz:294-99167 |
DOI: | https://doi.org/10.1111/dom.13924 |
Parent Title (English): | Diabetes, obesity and metabolism |
Subtitle (English): | a meta-analysis based on cardiovascular outcomes trials |
Publisher: | Wiley |
Place of publication: | Hoboken, New Jersey |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2023/05/25 |
Date of first Publication: | 2019/11/21 |
Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
Tag: | DPP-4 inhibitors; GLP-1 receptor agonists; cancer; cardiovascular outcomes trials (CVOTs); dipeptidyl peptidase-4; glucagon-like peptide (GLP-1); incretin-based medications; neoplasms; type 2 diabetes |
Volume: | 22 |
Issue: | 4 |
First Page: | 699 |
Last Page: | 704 |
Note: | Dieser Beitrag ist auf Grund des DEAL-Wiley-Vertrages frei zugänglich. |
Institutes/Facilities: | St. Josef-Hospital Bochum, Abteilung für Diabetologie und Gastrointestinale Endokrinologie |
Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
open_access (DINI-Set): | open_access |
Licence (English): | Creative Commons - CC BY-NC-ND 4.0 - Attribution-NonCommercial-NoDerivatives 4.0 International |