Incretin-based drugs and the risk of acute pancreatitis

Summary

Incretin-based drugs are medications prescribed to lower blood sugar levels in patients with type 2 diabetes. There is some limited evidence however, that incretin-based drugs may be associated with an increased risk of acute pancreatitis. This CNODES study evaluated the use of incretin-based drugs and the risk of acute pancreatitis in patients with type 2 diabetes.

Administrative data from five Canadian provinces (Alberta, Manitoba, Ontario, Quebec and Saskatchewan) and two international databases (United Kingdom Clinical Practice Research Datalink and United States MarketScan) were used to conduct this study. Using a common protocol, each site retrospectively constructed cohorts of patients with a new prescription for a non-insulin anti-diabetic drug after the date that incretin-based drugs had become available within their jurisdiction. The outcome of interest was a hospitalization for acute pancreatitis. Patients prescribed incretin-based drugs were compared to patients prescribed combinations of other oral antidiabetic drugs.

A nested case-control analysis, using risk-set sampling to match controls to cases, was performed on each cohort. Hazard ratios (HRs) were estimated using conditional logistic regression models, with adjustment for potential confounders. The site-specific results were meta-analyzed using random-effects models with inverse variance weighting.

Results

The health records of 1,532,513 patients were included in this study; 5,165 of which were hospitalized for acute pancreatitis during the follow-up period. Compared with those prescribed combinations of other oral antidiabetic drugs, the risk of acute pancreatitis was not increased in those taking incretin-based drugs [adjusted HR = 1.03; 95% CI = 0.87, 1.22]. Similarly, there was no association with duration of use or class of incretin-based drug.

The results of this large international study indicate that the use of incretin-based drugs is not associated with an increased risk of acute pancreatitis, relative to combinations of oral antidiabetic drugs. These findings should provide some reassurance to patients using incretin-based drugs with respect to their risk of acute pancreatitis.

Project Team

Project Co-Lead

Laurent Azoulay

Project Co-Lead

Pierre Ernst

Methods Lead

Robert Platt

Content Expert

Kristin Clemens

Lead Analyst

Matt Dahl

Liaisons

  • Tanvir Chowdhury TurinAlberta
  • Kristian FilionCPRD
  • Laura TargownikManitoba
  • Colin DormuthMarketScan
  • David JuurlinkOntario
  • Michael PatersonOntario
  • Madeleine DurandQuebec
  • Nianping HuSaskatchewan

Analysts

  • James ZhangAlberta
  • Zhihai MaAlberta
  • Hui YinCPRD
  • Matt DahlManitoba
  • Greg CarneyMarketScan
  • Fangyun WuOntario
  • Simon HollandsOntario
  • Menglan PangQuebec
  • Shan JinSaskatchewan

Additional Collaborators

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