Incretin-based therapy and risk of acute pancreatitis: a nationwide population-based case-control study

Reimar Wernich Thomsen, Lars Pedersen, Niels Møller, Johnny Kahlert, Henning Beck-Nielsen, Henrik Toft Sørensen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: To investigate whether the use of incretin-based drugs (GLP-1 receptor agonists and dipeptidyl peptidase 4 [DPP4] inhibitors) is associated with acute pancreatitis.

RESEARCH DESIGN AND METHODS: The study was a nationwide population-based case-control study using medical databases in Denmark. Participants were 12,868 patients with a first-time hospitalization for acute pancreatitis between 2005 and 2012 and a population of 128,680 matched control subjects. The main outcome measure was the odds ratio (OR) for acute pancreatitis associated with different antihyperglycemic drugs. We adjusted for history of gallstones, alcoholism, obesity, and other pancreatitis-associated comorbidities and medications.

RESULTS: A total of 89 pancreatitis patients (0.69%) and 684 control subjects (0.53%) were ever users of incretins. The crude OR for acute pancreatitis among incretin users was 1.36 (95% CI 1.08-1.69), while it was 1.44 (95% CI 1.34-1.54) among users of other antihyperglycemic drugs. After confounder adjustment, the risk of acute pancreatitis was not increased among incretin users (OR 0.95 [95% CI 0.75-1.21]), including DPP4 inhibitor users (OR 1.04 [95% CI 0.80-1.37]) or GLP-1 receptor agonist users (OR 0.82 [95% CI 0.54-1.23]), or among nonincretin antihyperglycemic drug users (OR 1.05 [95% CI 0.98-1.13]), compared with nonusers of any antihyperglycemic drugs. Findings were similar in current versus ever drug users and in patients with pancreatitis risk factors. The adjusted OR comparing incretin-based therapy with other antihyperglycemic therapy internally while also adjusting for diabetes duration and complications was 0.97 (95% CI 0.76-1.23).

CONCLUSIONS: Our findings suggest that the use of incretin-based drugs appears not to be associated with an increased risk of acute pancreatitis.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind38
Udgave nummer6
Sider (fra-til)1089-98
ISSN0149-5992
DOI
StatusUdgivet - jun. 2015

Fingeraftryk

Pancreatitis
Case-Control Studies
Odds Ratio
Hypoglycemic Agents
Population
Pharmaceutical Preparations
Drug Users
Social Adjustment
Gallstones
Diabetes Complications
Denmark
Alcoholism
Comorbidity
Outcome Assessment (Health Care)
Databases

Citer dette

Thomsen, Reimar Wernich ; Pedersen, Lars ; Møller, Niels ; Kahlert, Johnny ; Beck-Nielsen, Henning ; Sørensen, Henrik Toft. / Incretin-based therapy and risk of acute pancreatitis : a nationwide population-based case-control study. I: Diabetes Care. 2015 ; Bind 38, Nr. 6. s. 1089-98.
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title = "Incretin-based therapy and risk of acute pancreatitis: a nationwide population-based case-control study",
abstract = "OBJECTIVE: To investigate whether the use of incretin-based drugs (GLP-1 receptor agonists and dipeptidyl peptidase 4 [DPP4] inhibitors) is associated with acute pancreatitis.RESEARCH DESIGN AND METHODS: The study was a nationwide population-based case-control study using medical databases in Denmark. Participants were 12,868 patients with a first-time hospitalization for acute pancreatitis between 2005 and 2012 and a population of 128,680 matched control subjects. The main outcome measure was the odds ratio (OR) for acute pancreatitis associated with different antihyperglycemic drugs. We adjusted for history of gallstones, alcoholism, obesity, and other pancreatitis-associated comorbidities and medications.RESULTS: A total of 89 pancreatitis patients (0.69{\%}) and 684 control subjects (0.53{\%}) were ever users of incretins. The crude OR for acute pancreatitis among incretin users was 1.36 (95{\%} CI 1.08-1.69), while it was 1.44 (95{\%} CI 1.34-1.54) among users of other antihyperglycemic drugs. After confounder adjustment, the risk of acute pancreatitis was not increased among incretin users (OR 0.95 [95{\%} CI 0.75-1.21]), including DPP4 inhibitor users (OR 1.04 [95{\%} CI 0.80-1.37]) or GLP-1 receptor agonist users (OR 0.82 [95{\%} CI 0.54-1.23]), or among nonincretin antihyperglycemic drug users (OR 1.05 [95{\%} CI 0.98-1.13]), compared with nonusers of any antihyperglycemic drugs. Findings were similar in current versus ever drug users and in patients with pancreatitis risk factors. The adjusted OR comparing incretin-based therapy with other antihyperglycemic therapy internally while also adjusting for diabetes duration and complications was 0.97 (95{\%} CI 0.76-1.23).CONCLUSIONS: Our findings suggest that the use of incretin-based drugs appears not to be associated with an increased risk of acute pancreatitis.",
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Incretin-based therapy and risk of acute pancreatitis : a nationwide population-based case-control study. / Thomsen, Reimar Wernich; Pedersen, Lars; Møller, Niels; Kahlert, Johnny; Beck-Nielsen, Henning; Sørensen, Henrik Toft.

I: Diabetes Care, Bind 38, Nr. 6, 06.2015, s. 1089-98.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Incretin-based therapy and risk of acute pancreatitis

T2 - a nationwide population-based case-control study

AU - Thomsen, Reimar Wernich

AU - Pedersen, Lars

AU - Møller, Niels

AU - Kahlert, Johnny

AU - Beck-Nielsen, Henning

AU - Sørensen, Henrik Toft

N1 - © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

PY - 2015/6

Y1 - 2015/6

N2 - OBJECTIVE: To investigate whether the use of incretin-based drugs (GLP-1 receptor agonists and dipeptidyl peptidase 4 [DPP4] inhibitors) is associated with acute pancreatitis.RESEARCH DESIGN AND METHODS: The study was a nationwide population-based case-control study using medical databases in Denmark. Participants were 12,868 patients with a first-time hospitalization for acute pancreatitis between 2005 and 2012 and a population of 128,680 matched control subjects. The main outcome measure was the odds ratio (OR) for acute pancreatitis associated with different antihyperglycemic drugs. We adjusted for history of gallstones, alcoholism, obesity, and other pancreatitis-associated comorbidities and medications.RESULTS: A total of 89 pancreatitis patients (0.69%) and 684 control subjects (0.53%) were ever users of incretins. The crude OR for acute pancreatitis among incretin users was 1.36 (95% CI 1.08-1.69), while it was 1.44 (95% CI 1.34-1.54) among users of other antihyperglycemic drugs. After confounder adjustment, the risk of acute pancreatitis was not increased among incretin users (OR 0.95 [95% CI 0.75-1.21]), including DPP4 inhibitor users (OR 1.04 [95% CI 0.80-1.37]) or GLP-1 receptor agonist users (OR 0.82 [95% CI 0.54-1.23]), or among nonincretin antihyperglycemic drug users (OR 1.05 [95% CI 0.98-1.13]), compared with nonusers of any antihyperglycemic drugs. Findings were similar in current versus ever drug users and in patients with pancreatitis risk factors. The adjusted OR comparing incretin-based therapy with other antihyperglycemic therapy internally while also adjusting for diabetes duration and complications was 0.97 (95% CI 0.76-1.23).CONCLUSIONS: Our findings suggest that the use of incretin-based drugs appears not to be associated with an increased risk of acute pancreatitis.

AB - OBJECTIVE: To investigate whether the use of incretin-based drugs (GLP-1 receptor agonists and dipeptidyl peptidase 4 [DPP4] inhibitors) is associated with acute pancreatitis.RESEARCH DESIGN AND METHODS: The study was a nationwide population-based case-control study using medical databases in Denmark. Participants were 12,868 patients with a first-time hospitalization for acute pancreatitis between 2005 and 2012 and a population of 128,680 matched control subjects. The main outcome measure was the odds ratio (OR) for acute pancreatitis associated with different antihyperglycemic drugs. We adjusted for history of gallstones, alcoholism, obesity, and other pancreatitis-associated comorbidities and medications.RESULTS: A total of 89 pancreatitis patients (0.69%) and 684 control subjects (0.53%) were ever users of incretins. The crude OR for acute pancreatitis among incretin users was 1.36 (95% CI 1.08-1.69), while it was 1.44 (95% CI 1.34-1.54) among users of other antihyperglycemic drugs. After confounder adjustment, the risk of acute pancreatitis was not increased among incretin users (OR 0.95 [95% CI 0.75-1.21]), including DPP4 inhibitor users (OR 1.04 [95% CI 0.80-1.37]) or GLP-1 receptor agonist users (OR 0.82 [95% CI 0.54-1.23]), or among nonincretin antihyperglycemic drug users (OR 1.05 [95% CI 0.98-1.13]), compared with nonusers of any antihyperglycemic drugs. Findings were similar in current versus ever drug users and in patients with pancreatitis risk factors. The adjusted OR comparing incretin-based therapy with other antihyperglycemic therapy internally while also adjusting for diabetes duration and complications was 0.97 (95% CI 0.76-1.23).CONCLUSIONS: Our findings suggest that the use of incretin-based drugs appears not to be associated with an increased risk of acute pancreatitis.

U2 - 10.2337/dc13-2983

DO - 10.2337/dc13-2983

M3 - Journal article

C2 - 25633664

VL - 38

SP - 1089

EP - 1098

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

IS - 6

ER -