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Use of incretin agents and risk of acute and chronic pancreatitis: A population‐based cohort study
Author(s) -
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
Publication year - 2017
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.12833
Subject(s) - medicine , incretin , pancreatitis , hazard ratio , diabetes mellitus , cohort , acute pancreatitis , population , sitagliptin , type 2 diabetes , cohort study , proportional hazards model , gastroenterology , confidence interval , endocrinology , environmental health
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.