We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Association Between Incretin-Based Drugs and the Risk of Acute Pancreatitis.
- Authors
Azoulay, Laurent; Filion, Kristian B.; Platt, Robert W.; Dahl, Matthew; Dormuth, Colin R.; Clemens, Kristin K.; Durand, Madeleine; Nianping Hu; Juurlink, David N.; Paterson, J. Michael; Targownik, Laura E.; Turin, Tanvir C.; Ernst, Pierre; Hu, Nianping; and the Canadian Network for Observational Drug Effect Studies (CNODES) Investigators; Suissa, Samy; Hemmelgarn, Brenda R; Teare, Gary F; Caetano, Patricia; Chateau, Dan
- Abstract
<bold>Importance: </bold>The association between incretin-based drugs, such as dipeptidyl peptidase 4 (DPP-4) inhibitors and glucagon-like peptide 1 (GLP-1) agonists, and acute pancreatitis is controversial.<bold>Objective: </bold>To determine whether the use of incretin-based drugs, compared with the use of 2 or more other oral antidiabetic drugs, is associated with an increased risk of acute pancreatitis.<bold>Design, Setting, and Participants: </bold>A large, international, multicenter, population-based cohort study was conducted using combined health records from 7 participating sites in Canada, the United States, and the United Kingdom. An overall cohort of 1 532 513 patients with type 2 diabetes initiating the use of antidiabetic drugs between January 1, 2007, and June 30, 2013, was included, with follow-up until June 30, 2014.<bold>Exposures: </bold>Current use of incretin-based drugs compared with current use of at least 2 oral antidiabetic drugs.<bold>Main Outcomes and Measures: </bold>Nested case-control analyses were conducted including hospitalized patients with acute pancreatitis matched with up to 20 controls on sex, age, cohort entry date, duration of treated diabetes, and follow-up duration. Hazard ratios (HRs) and 95% CIs for hospitalized acute pancreatitis were estimated and compared current use of incretin-based drugs with current use of 2 or more oral antidiabetic drugs. Secondary analyses were performed to assess whether the risk varied by class of drug (DPP-4 inhibitors and GLP-1 agonists) or by duration of use. Site-specific HRs were pooled using random-effects models.<bold>Results: </bold>Of 1 532 513 patients included in the analysis, 781 567 (51.0%) were male; mean age was 56.6 years. During 3 464 659 person-years of follow-up, 5165 patients were hospitalized for acute pancreatitis (incidence rate, 1.49 per 1000 person-years). Compared with current use of 2 or more oral antidiabetic drugs, current use of incretin-based drugs was not associated with an increased risk of acute pancreatitis (pooled adjusted HR, 1.03; 95% CI, 0.87-1.22). Similarly, the risk did not vary by drug class (DPP-4 inhibitors: pooled adjusted HR, 1.09; 95% CI, 0.86-1.22; GLP-1 agonists: pooled adjusted HR, 1.04; 95% CI, 0.81-1.35) and there was no evidence of a duration-response association.<bold>Conclusions and Relevance: </bold>In this large population-based study, use of incretin-based drugs was not associated with an increased risk of acute pancreatitis compared with other oral antidiabetic drugs.
- Subjects
CANADA; UNITED States; COMPARATIVE studies; HYPOGLYCEMIC agents; LONGITUDINAL method; RESEARCH methodology; INCRETINS; MEDICAL cooperation; TYPE 2 diabetes; PANCREATITIS; RESEARCH; GLUCAGON-like peptide 1; PROTEASE inhibitors; EVALUATION research; CASE-control method
- Publication
JAMA Internal Medicine, 2016, Vol 176, Issue 10, p1464
- ISSN
2168-6106
- Publication type
journal article
- DOI
10.1001/jamainternmed.2016.1522