Incretin-based pharmacotherapy and risk of adverse pancreatic events in the ethnic Chinese with diabetes mellitus: A population-based study in Taiwan
Journal
Pancreatology
Journal Volume
17
Journal Issue
1
Pages
76-82
Date Issued
2017
Author(s)
Abstract
Background Pancreatic safety remains a concern for diabetic patients using incretin-based medications. We aimed to determine if there was an association between incretin-based therapy and an increased risk for acute pancreatitis and pancreatic cancer in patients with type 2 diabetes mellitus (DM). Methods This retrospective population-based cohort study analyzed data from the Taiwan National Health Insurance Research Database. A total of 13?171 eligible type 2 DM patients who had received incretin-based treatment for a minimum of two months were matched 1:1 for age, gender, diabetes complications severity index, and inception date with DM patients who never used this pharmacotherapy. The cohorts were compared for occurrence of acute pancreatitis and pancreatic cancer. The association between incretin-based therapy and acute pancreatitis was assessed using a Cox proportional hazard model and stratified analyses. Results Acute pancreatitis occurred in 71 (0.54%) incretin users and 66 (0.50%) non-users, respectively (P?=?0.67). The association remained insignificant (adjusted hazard ratio [HR], 1.06; 95% confidence interval [CI]?=?0.72–1.55) after adjustment for cholelithiasis (adjusted HR, 2.76; 95% CI?=?1.32–5.75) and alcohol-related disease (adjusted HR 9.14, 95% CI?=?2.08–40.14) in the Cox model. Stratified analyses affirmed no association between incretin-based therapy and pancreatitis in any subgroup. Pancreatic cancer occurred in 6 (0.05%) and 10 (0.08%) patients in the user and non-user cohort, respectively (P?=?0.32). Conclusion Incretin-based therapy is not associated with acute pancreatitis and short-term pancreatic cancer risk among ethnic Chinese patients with diabetes. This study supports the pancreatic safety of incretin-based pharmacotherapy. ? 2016 IAP and EPC
Subjects
Acute pancreatitis; Dipeptidyl peptidase-4 inhibitors; Glucagon-like peptide-1 receptor agonists; Incretin-based therapies; Pancreatic cancer
SDGs
Other Subjects
incretin; antidiabetic agent; incretin; acute pancreatitis; adult; aged; alcohol liver disease; Article; Chinese; cholelithiasis; cohort analysis; controlled study; diabetic patient; drug therapy; drug use; female; human; hypertriglyceridemia; major clinical study; male; middle aged; non insulin dependent diabetes mellitus; pancreas cancer; priority journal; retrospective study; risk factor; Taiwan; treatment duration; very elderly; acute disease; chemically induced; China; complication; Diabetes Mellitus, Type 2; ethnology; factual database; longitudinal study; pancreas tumor; pancreatitis; proportional hazards model; Acute Disease; Adult; Aged; Aged, 80 and over; China; Databases, Factual; Diabetes Mellitus, Type 2; Female; Humans; Hypoglycemic Agents; Incretins; Longitudinal Studies; Male; Middle Aged; Pancreatic Neoplasms; Pancreatitis; Proportional Hazards Models; Retrospective Studies; Risk Factors; Taiwan
Publisher
Elsevier B.V.
Type
journal article