Sitagliptin and pancreatic cancer risk in patients with type 2 diabetes
Journal
European Journal of Clinical Investigation
Journal Volume
46
Journal Issue
1
Pages
70-79
Date Issued
2016
Author(s)
Abstract
Background: The risk of pancreatic cancer associated with incretin-based therapies is controversial. Methods: This study retrospectively analysed the National Health Insurance database including patients with newly diagnosed type 2 diabetes mellitus at an age ? 25 years between 1999 and 2010. A total of 71 137 ever users of sitagliptin and 933 046 never users were followed for pancreatic cancer until 31 December 2011. A time-dependent approach was used to calculate incidence and estimate hazard ratios adjusted for propensity score using Cox regression. Results: During follow-up, 83 ever users and 3658 never users developed pancreatic cancer, representing an incidence of 73·6 and 55·0 per 100 000 person-years, respectively. The adjusted hazard ratio (95% confidence intervals) for ever versus never users was 1·40 (1·13-1·75). The respective adjusted hazard ratio for the first, second and third tertile of cumulative dose < 14 700, 14 700-33 700 and > 33 700 mg was 1·83 (1·28-2·62), 1·97 (1·41-2·76) and 0·72 (0·45-1·15). For average daily dose of < 50, 50-99·9 and ? 100 mg, the respective hazard ratio was 3·10 (1·17-8·26), 1·01 (0·63-1·61) and 1·53 (1·18-1·97). Conclusions: Sitagliptin is significantly associated with a higher risk of pancreatic cancer, especially when the cumulative dose is < 33 700 mg. The risk diminished in users with a higher cumulative dose. The daily dose of sitagliptin should better be kept < 100 mg, and its use should be reconsidered in patients who suffer from severe renal impairment and thus a daily dose of < 50 mg is always recommended. Future studies are required to confirm the findings with more appropriate adjustment for smoking. ? 2016 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.
Subjects
Incretin; National Health Insurance; Pancreatic cancer; Sitagliptin; Taiwan
SDGs
Other Subjects
sitagliptin; antidiabetic agent; sitagliptin; adult; Article; cancer incidence; cancer risk; controlled study; female; follow up; hazard ratio; human; major clinical study; male; non insulin dependent diabetes mellitus; pancreas cancer; priority journal; propensity score; retrospective study; aged; carcinoma; Carcinoma, Pancreatic Ductal; case control study; Diabetes Mellitus, Type 2; incidence; middle aged; Pancreatic Neoplasms; proportional hazards model; risk factor; Taiwan; Adult; Aged; Carcinoma; Carcinoma, Pancreatic Ductal; Case-Control Studies; Diabetes Mellitus, Type 2; Female; Humans; Hypoglycemic Agents; Incidence; Male; Middle Aged; Pancreatic Neoplasms; Propensity Score; Proportional Hazards Models; Retrospective Studies; Risk Factors; Sitagliptin Phosphate; Taiwan
Publisher
Blackwell Publishing Ltd
Type
journal article