Use of incretin agents and risk of acute and chronic pancreatitis: a population-based cohort study

Autor: Yolande C. Keulemans, Nielka P. van Erp, Sander Croes, Roy G.P.J. de Jong, Johanna H M Driessen, Marie L. De Bruin, Hubert G. M. Leufkens, Frank de Vries, Lotte M. Knapen
Přispěvatelé: Promovendi PHPC, Epidemiologie, MUMC+: DA KFT Medische Staf (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Promovendi ODB, Interne Geneeskunde, RS: CAPHRI - R5 - Optimising Patient Care, RS: CAPHRI - R4 - Health Inequities and Societal Participation, Farmacologie en Toxicologie, Pharmacoepidemiology and Clinical Pharmacology, Afd Pharmacoepi & Clinical Pharmacology
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Databases
Factual
type 2 diabetes mellitus
Endocrinology
Diabetes and Metabolism
THERAPIES
0302 clinical medicine
Endocrinology
cohort studies
Risk Factors
Taverne
030212 general & internal medicine
glucagon-like peptide-1 receptor agonists
education.field_of_study
Hazard ratio
ASSOCIATION
EXPANSION
Middle Aged
CANCER
Urological cancers Radboud Institute for Health Sciences [Radboudumc 15]
Acute Disease
Acute pancreatitis
Female
Cohort study
Adult
medicine.medical_specialty
Adolescent
acute pancreatitis
Population
Incretin
030209 endocrinology & metabolism
Incretins
Glucagon-Like Peptide-1 Receptor
RATS
chronic pancreatitis
Young Adult
03 medical and health sciences
Pancreatitis
Chronic
Internal medicine
BENEFITS
Internal Medicine
medicine
Humans
Hypoglycemic Agents
DRUGS
Pancreatitis
chronic
education
Intensive care medicine
METAANALYSIS
Aged
Proportional Hazards Models
Dipeptidyl-Peptidase IV Inhibitors
business.industry
Case-control study
medicine.disease
United Kingdom
Diabetes Mellitus
Type 2
Pancreatitis
Case-Control Studies
UPDATE
incretin-based therapy
business
dipeptidyl peptidase-4 inhibitors
SYSTEM
Zdroj: Diabetes, Obesity & Metabolism, 19, 3, pp. 401-411
Diabetes, Obesity and Metabolism, 19(3). Wiley-Blackwell
Diabetes, Obesity & Metabolism, 19, 401-411
Diabetes Obesity & Metabolism, 19(3), 401-411. Wiley
Publons
ISSN: 1462-8902
DOI: 10.1111/dom.12833
Popis: Background Incretin-based therapies (Dipeptidyl Peptidase 4 inhibitors and Glucagon-Like Peptide-1 Receptor Agonists) are effective new agents for the treatment of Type 2 Diabetes Mellitus (T2DM). While incretin-based therapies have been associated with pancreatitis, evidence is conflicting for acute pancreatitis and lacks for chronic pancreatitis. Objective To determine the association between the use of incretin agents 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). 182,428 adult patients with ≥1 Non-Insulin Antidiabetic Drug (NIAD) prescriptions were matched to non-diabetic controls. Cox regression estimated adjusted hazard ratios (HRa) and 95% Confidence Intervals (CI) of pancreatitis in incretin-users (N = 28,370) compared to controls and to 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 versus NIAD users (HRa 1.47; 95% CI 1.06–2.04). In incident current incretin users the risk of any and acute pancreatitis was increased by 2.1 and 2.0-fold versus NIAD users (HRa 2.12; 95% CI 1.31-3.43 and HRa 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 could not detect an association with chronic pancreatitis, but numbers in this subgroup were small.
Databáze: OpenAIRE
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