Matteo Monami1, Ilaria Dicembrini2, Camilla Nardini1, Irene Fiordelli1, Edoardo Mannucci3. 1. Section of Geriatric Cardiology and Medicine, Careggi Teaching Hospital, Via delle Oblate 4, 50141 Florence, Italy. 2. Obesity Agency, Careggi Teaching Hospital, Via delle Oblate 4, 50141 Florence, Italy; Diabetes Agency, Careggi Teaching Hospital, Via delle Oblate 4, 50141 Florence, Italy. 3. Diabetes Agency, Careggi Teaching Hospital, Via delle Oblate 4, 50141 Florence, Italy. Electronic address: edoardo.mannucci@unifi.com.
Abstract
AIMS: Several randomized trials with metabolic outcomes have reported that glucagon like peptide-1 receptor agonists (GLP-1 RA) could be associated with an increased risk of pancreatitis. The present meta-analysis aimed to examine this hypothesis. METHODS: An extensive Medline, Embase, and Cochrane Database search for "exenatide", "liraglutide", "albiglutide", "taspoglutide", "dulaglutide", "lixisenatide", and "semaglutide" was performed up to March 31st, 2013. INCLUSION CRITERIA: (i) randomized trials, (ii) duration ≥12 weeks; (iii) on type 2 diabetes; and (iv) comparison of GLP-1RA with placebo or active drugs. Mantel-Haenszel odds ratio with 95% confidence interval (MH-OR) was calculated for pancreatitis. RESULTS: 80 eligible trials were identified. Of these, 39 had not disclosed their findings or did not report any information on pancreatitis. The remaining 41 trials enrolled 14,972 patients, with a total exposure of 14,333 patient × years (8353 and 5980 patient × years for GLP-1 receptor agonists and comparators, respectively). The overall risk of pancreatitis was not different between GLP-1RA and comparators (MH-OR: 1.01[0.37; 2.76]; p = 0.99). CONCLUSIONS: The present meta-analysis does not suggest any increase in the risk of pancreatitis with the use of GLP-1RA. However, it should be recognized that the number of observed cases of incident pancreatitis is very small and the confidence intervals of risk estimates are wide.
AIMS: Several randomized trials with metabolic outcomes have reported that glucagon like peptide-1 receptor agonists (GLP-1RA) could be associated with an increased risk of pancreatitis. The present meta-analysis aimed to examine this hypothesis. METHODS: An extensive Medline, Embase, and Cochrane Database search for "exenatide", "liraglutide", "albiglutide", "taspoglutide", "dulaglutide", "lixisenatide", and "semaglutide" was performed up to March 31st, 2013. INCLUSION CRITERIA: (i) randomized trials, (ii) duration ≥12 weeks; (iii) on type 2 diabetes; and (iv) comparison of GLP-1RA with placebo or active drugs. Mantel-Haenszel odds ratio with 95% confidence interval (MH-OR) was calculated for pancreatitis. RESULTS: 80 eligible trials were identified. Of these, 39 had not disclosed their findings or did not report any information on pancreatitis. The remaining 41 trials enrolled 14,972 patients, with a total exposure of 14,333 patient × years (8353 and 5980 patient × years for GLP-1 receptor agonists and comparators, respectively). The overall risk of pancreatitis was not different between GLP-1RA and comparators (MH-OR: 1.01[0.37; 2.76]; p = 0.99). CONCLUSIONS: The present meta-analysis does not suggest any increase in the risk of pancreatitis with the use of GLP-1RA. However, it should be recognized that the number of observed cases of incident pancreatitis is very small and the confidence intervals of risk estimates are wide.
Authors: Teresa Vanessa Fiorentino; Michael Owston; Gregory Abrahamian; Stefano La Rosa; Alessandro Marando; Carla Perego; Eliana S Di Cairano; Giovanna Finzi; Carlo Capella; Fausto Sessa; Francesca Casiraghi; Ana Paez; Ashwin Adivi; Alberto Davalli; Paolo Fiorina; Rodolfo Guardado Mendoza; Anthony G Comuzzie; Mark Sharp; Ralph A DeFronzo; Glenn Halff; Edward J Dick; Franco Folli Journal: Am J Pathol Date: 2014-11-06 Impact factor: 4.307