10 Jul Incretin-based drugs and the risk of pancreatic cancer (Q13-06B)
Incretin-based drugs and the risk of pancreatic cancer (Q13-06B)
Overview
What is the issue
- Incretin-based drugs are popular therapies for the treatment of type 2 diabetes.
- However, their safety is controversial, with some studies associating their use with an increased risk of pancreatic cancer.
What was the aim of the study?
- This study assessed whether the use of incretin-based drugs, when compared with sulfonylureas, is associated with an increased risk of pancreatic cancer in patients with type 2 diabetes.
How was the study conducted?
- Our researchers conducted six population-based studies with the health records of 972,384 patients from four Canadian provinces and two international databases.
- In each study, the risk of newly-diagnosed pancreatic cancer was compared in users of incretin-based drugs versus users of sulfonylureas.
- Information was then combined across studies using a statistical approach called meta-analysis.
What did the study find?
- In the largest study conducted to date, the use of incretin-based drugs was not associated with an increased risk of pancreatic cancer, when compared to sulfonylureas.
- Similarly, there was no evidence of a duration-response relationship, and the findings remained consistent in several sensitivity analyses.
- These findings should provide considerable reassurance to patients and clinicians with concerns of an association between incretin-based drugs and pancreatic cancer.
Implications
- These findings should provide reassurance to patients and physicians using these drugs.
Key message
- The use of incretin-based drugs, therapies prescribed for the treatment of type 2 diabetes, is not associated with an increased risk of pancreatic cancer, when compared with sulfonylureas.
Links
Protocol RegistrationManuscripts
Secrest M, Udell JA, Filion KB. The cardiovascular safety trials of DPP-4 inhibitors, GLP-1 agonists, and SGLT2 inhibitors. Trends Cardiovasc Med 2017 Apr;27(3):194-202.
Filion KB, Suissa S. DPP-4 inhibitors and heart failure: Some reassurance, some uncertainty. Diabetes Care 2016 May; 39(5):735–737. [Invited Commentary].
Azoulay L, Filion B, Platt R, Dahl M, Dormuth C, Clemens K, Durand M, Hu N, Juurlink D, Paterson M, Targownik L, Turin T, Ernst P, CNODES Investigators. Association Between Incretin-Based Drugs and the Risk of Acute Pancreatitis. JAMA Intern Med. 2016 Oct 1;176(10):1464-1473.
Azoulay L, Filion KB, Platt R, Dahl M, Dormuth C, Clemens K, Durand M, Juurlink DN, Targownik L, Turin T, Paterson M, Ernst P; CNODES Investigators. Incretin based drugs and the risk of pancreatic cancer: international multicentre cohort study. BMJ. 2016 Feb 17;352:i581.
Filion KB, Azoulay L, Platt R, Dahl M, Dormuth C, Clemens K, Hu N, Paterson M, Targownik L, Turin T, Udell J, Ernst P; CNODES Investigators. A Multicenter Observational Study of Incretin-based Drugs and Heart Failure. N Engl J Med. 2016 Mar 24;374(12):1145-54.