title: A meta-analysis of serious adverse events reported with exenatide and liraglutide: acute pancreatitis and cancer.
abstract: OBJECTIVE
  The association between GLP-1 agonists, acute pancreatitis (AP), any cancer and thyroid cancer is discussed. This meta-analysis was aimed at evaluating the risk of those serious adverse events associated with GLP-1 agonists in patients with type 2 diabetes.
  
  
  METHODS
  Medline, EMBASE, Cochrane Library and clinicaltrials.gov were searched in order to identify longitudinal studies evaluating exenatide or liraglutide use and reporting data on AP or cancer. Odds ratios (ORs) were pooled using a random-effects model. I(2) statistics assessed heterogeneity.
  
  
  RESULTS
  Twenty-five studies were included. Neither exenatide (OR 0.84 [95% CI 0.58-1.22], I(2) = 30%) nor liraglutide (OR 0.97 [95% CI 0.21-4.39], I(2) = 0%) were associated with an increased risk of AP, independent of baseline comparator. The pooled OR for cancer associated with exenatide was 0.86 (95% CI 0.29, 2.60, I(2) = 0%) and for liraglutide was 1.35 (95% CI 0.70, 2.59, I(2) = 0%). Liraglutide was not associated with an increased risk for thyroid cancer (OR 1.54 [95% CI 0.40-6.02], I(2) = 0%). For exenatide, no thyroid malignancies were reported.
  
  
  CONCLUSIONS
  Current available published evidence is insufficient to support an increased risk of AP or cancer associated with GLP-1 agonists. These rare and long-term adverse events deserve properly monitoring in future studies evaluating GLP-1 agonists.
authors.affiliation: Health Technology Assessment (HTA) Centre, AIBILI, Coimbra, Portugal. carlosmiguel.costaalves@gmail.com
authors.forename: Carlos
authors.initials: C
authors.lastname: Alves
authors.forename: Francisco
authors.initials: F
authors.lastname: Batel-Marques
authors.forename: Ana F
authors.initials: AF
authors.lastname: Macedo
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1 / Q000009:adverse effects / Q000819:agonists* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000069450:Liraglutide; D009369:Neoplasms / Q000139:chemically induced*; D010195:Pancreatitis / Q000139:chemically induced*; D010455:Peptides / Q000009:adverse effects* / Q000627:therapeutic use; D014688:Venoms / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D010455:Peptides; D014688:Venoms; D000069450:Liraglutide; D052216:Glucagon-Like Peptide 1; D000077270:Exenatide