TY - JOUR
T1 - Incretin-based drugs and risk of acute pancreatitis
T2 - A nested-case control study within a healthcare database
AU - Soranna, Davide
AU - Bosetti, Cristina
AU - Casula, Manuela
AU - Tragni, Elena
AU - Catapano, Alberico L.
AU - Vecchia, Carlo L A
AU - Merlino, Luca
AU - Corrao, Giovanni
PY - 2015/5/1
Y1 - 2015/5/1
N2 - To assess the association between use of incretin-based drugs for diabetes mellitus and the occurrence of acute pancreatitis.A population-based, nested case-control study was performed within a cohort of 166,591 patients from the Lombardy region (Italy) aged 40 years or older who were newly treated with oral antihyperglycaemic agents between 2004 and 2007. Cases were 666 patients who experienced acute pancreatitis from April 1, 2008 until December 31, 2012. For each case patient, up to 20 controls were randomly selected from the cohort and matched on gender, age at cohort entry, and date of index prescription. Conditional logistic regression was used to model the risk of acute pancreatitis associated with use of incretin-based drugs within 30 days before hospitalization, after adjustment for several risk factors, including the use of other antihyperglycaemic agents. Sensitivity analyses were performed in order to account for possible sources of systematic uncertainty.Use of incretin-based drugs within 30 days was reported by 17 (2.6%) cases of acute pancreatitis versus 193 (1.5%) controls. The corresponding multivariate odds ratio was 1.75 (95% confidence interval, 1.02 to 2.99). Slightly lower and no significant excess risks were observed by shortening (15 days) and increasing (60 and 90 days) the time-window at risk.This study supports a possible increased risk of acute pancreatitis in relation to use of incretin-baseddrugs reported in a few previous studies. However, given the potential for bias and the inconsistency with other studies, additional investigations are needed to clarify the safety of incretin-based-drugs.
AB - To assess the association between use of incretin-based drugs for diabetes mellitus and the occurrence of acute pancreatitis.A population-based, nested case-control study was performed within a cohort of 166,591 patients from the Lombardy region (Italy) aged 40 years or older who were newly treated with oral antihyperglycaemic agents between 2004 and 2007. Cases were 666 patients who experienced acute pancreatitis from April 1, 2008 until December 31, 2012. For each case patient, up to 20 controls were randomly selected from the cohort and matched on gender, age at cohort entry, and date of index prescription. Conditional logistic regression was used to model the risk of acute pancreatitis associated with use of incretin-based drugs within 30 days before hospitalization, after adjustment for several risk factors, including the use of other antihyperglycaemic agents. Sensitivity analyses were performed in order to account for possible sources of systematic uncertainty.Use of incretin-based drugs within 30 days was reported by 17 (2.6%) cases of acute pancreatitis versus 193 (1.5%) controls. The corresponding multivariate odds ratio was 1.75 (95% confidence interval, 1.02 to 2.99). Slightly lower and no significant excess risks were observed by shortening (15 days) and increasing (60 and 90 days) the time-window at risk.This study supports a possible increased risk of acute pancreatitis in relation to use of incretin-baseddrugs reported in a few previous studies. However, given the potential for bias and the inconsistency with other studies, additional investigations are needed to clarify the safety of incretin-based-drugs.
KW - Acute pancreatitis
KW - Antihyperglycaemic agents
KW - Drug safety
KW - Healthcare databases
KW - Incretin-based drugs
KW - Nested case-control study
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U2 - 10.1016/j.diabres.2015.02.013
DO - 10.1016/j.diabres.2015.02.013
M3 - Article
C2 - 25748827
AN - SCOPUS:84927910321
VL - 108
SP - 243
EP - 249
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
SN - 0168-8227
IS - 2
ER -