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Dipeptidyl peptidase‐4 inhibitors and pancreatitis risk: a meta‐analysis of randomized clinical trials
Author(s) -
Monami M.,
Dicembrini I.,
Mannucci E.
Publication year - 2014
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12176
Subject(s) - alogliptin , sitagliptin , saxagliptin , medicine , pancreatitis , odds ratio , randomized controlled trial , vildagliptin , linagliptin , meta analysis , relative risk , dipeptidyl peptidase 4 inhibitor , placebo , confidence interval , diabetes mellitus , type 2 diabetes , endocrinology , insulin , pathology , metformin , alternative medicine
Aim Some observational studies reporting an increased risk of pancreatitis in association with Dipeptidyl Peptidase‐4 inhibitors ( DPP4i ) have raised concerns on the overall safety of this class. Aim of the present meta‐analysis is the systematic collection of information on pancreatitis in randomized clinical trials with DPP4i . Methods Data Sources: an extensive Medline, Embase and Cochrane Database search for ‘vildagliptin’, ‘sitagliptin’, ‘saxagliptin’, ‘alogliptin’, ‘linagliptin’ and ‘dutogliptin’ was performed up to 1 March 2013. Study Selection: studies were included if they satisfied the following criteria: (i) randomized trials, (ii) duration ≥12 weeks, (iii) on type 2 diabetes and (iv) comparison of DPP4i with placebo or active drugs. The identification and the selection of studies, and the subsequent data extraction were performed independently by two authors. Mantel‐Haenszel odds ratio with 95% Confidence Interval ( MH‐OR ) was calculated for all the adverse events defined below. The principal outcome was the effect of DPP4i on the incidence of pancreatitis. Results A total of 134 eligible trials were identified. The overall risk of pancreatitis and pancreatic cancer was not different between DPP4i and comparators ( MH‐OR : 0.93[0.51–1.69]; p = 0.82). Conclusions It should be recognized that the number of observed cases of incident pancreatitis is small and the confidence intervals of risk estimates are wide. However, the present meta‐analysis do not suggest any increase in the risk of pancreatitis with DPP4i .