title: Dipeptidyl peptidase-4 inhibitors and pancreatitis risk: a meta-analysis of randomized clinical trials.
abstract: OBJECTIVE
  Some observational studies reporting an increased risk of pancreatitis in association with Dipeptidyl Peptidase-4 inhibitors (DPP4i) have raised concerns on the overall safety of this class. Aim of the present meta-analysis is the systematic collection of information on pancreatitis in randomized clinical trials with DPP4i.
  
  
  METHODS
  
  
  
  METHODS
  an extensive Medline, Embase and Cochrane Database search for 'vildagliptin', 'sitagliptin', 'saxagliptin', 'alogliptin', 'linagliptin' and 'dutogliptin' was performed up to 1 March 2013.
  
  
  METHODS
  studies were included if they satisfied the following criteria: (i) randomized trials, (ii) duration ≥12 weeks, (iii) on type 2 diabetes and (iv) comparison of DPP4i with placebo or active drugs. The identification and the selection of studies, and the subsequent data extraction were performed independently by two authors. Mantel-Haenszel odds ratio with 95% Confidence Interval (MH-OR) was calculated for all the adverse events defined below. The principal outcome was the effect of DPP4i on the incidence of pancreatitis.
  
  
  RESULTS
  A total of 134 eligible trials were identified. The overall risk of pancreatitis and pancreatic cancer was not different between DPP4i and comparators (MH-OR: 0.93[0.51-1.69]; p = 0.82).
  
  
  CONCLUSIONS
  It should be recognized that the number of observed cases of incident pancreatitis is small and the confidence intervals of risk estimates are wide. However, the present meta-analysis do not suggest any increase in the risk of pancreatitis with DPP4i.
authors.affiliation: Section of Geriatric Cardiology and Medicine, Careggi Teaching Hospital, Florence, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Monami
authors.forename: I
authors.initials: I
authors.lastname: Dicembrini
authors.forename: E
authors.initials: E
authors.lastname: Mannucci
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010190:Pancreatic Neoplasms / Q000139:chemically induced*; D010195:Pancreatitis / Q000139:chemically induced*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors
keywords: antidiabetic drug; meta-analysis; type 2 diabetes