title: Incretin therapies and risk of hospital admission for acute pancreatitis in an unselected population of European patients with type 2 diabetes: a case-control study.
abstract: BACKGROUND
  Previous studies have yielded conflicting results about the association between incretin therapies and acute pancreatitis. We aimed to compare the occurrence of acute pancreatitis in a population of patients with type 2 diabetes who received incretins compared with those who received other antidiabetic treatment.
  
  
  METHODS
  In our population-based matched case-control study, we extracted information from an administrative database from Piedmont, Italy (containing data for 4·4 million inhabitants). From a dataset of 282,429 patients receiving treatment with antidiabetic drugs for type 2 diabetes, we identified 1003 cases older than 41 years who had been admitted to hospital for acute pancreatitis between Jan 1, 2008, and Dec 31, 2012, and 4012 controls who were matched for sex, age, and time of start of antidiabetic therapy. We compared incretin exposure in cases and controls with a conditional logistic regression model, expressed as odds ratios (ORs [95% CI]). We adjusted all analyses for risk factors of acute pancreatitis, as ascertained by hospital discharge records, and concomitant use of metformin or glibenclamide.
  
  
  RESULTS
  The mean age of cases and controls (72·2 years [SD 11·1]) was high, as expected in an unselected diabetic population in Europe. After adjustment for available confounders, use of incretins in the 6 months before hospital admission was not associated with increased risk of acute pancreatitis (OR 0·98, 95% CI 0·69-1·38; p=0·8958).
  
  
  CONCLUSIONS
  Our findings suggest that, in an unselected population, use of incretins is not associated with an increased risk of acute pancreatitis. Larger studies are needed to clarify whether age or type of incretin therapy could affect the risk of acute pancreatitis in patients with type 2 diabetes.
  
  
  BACKGROUND
  Chaira Medica Association, Chieri, Italy.
authors.affiliation: Metabolism and Diabetes Unit, ASL TO5, Regione Piemonte, Chieri, Italy. Electronic address: giordaca@tin.it.
authors.forename: Carlo B
authors.initials: CB
authors.lastname: Giorda
authors.affiliation: Epidemiology Unit, ASL TO3, Regione Piemonte, Grugliasco, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Picariello
authors.affiliation: Chaira Medica Association, Chieri, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Nada
authors.affiliation: Chaira Medica Association, Chieri, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Tartaglino
authors.affiliation: Metabolism and Diabetes Unit, ASL TO5, Regione Piemonte, Chieri, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Marafetti
authors.affiliation: Epidemiology Unit, ASL TO3, Regione Piemonte, Grugliasco, Italy; Department of Public Health, University of Torino, Torino, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costa
authors.affiliation: Epidemiology Unit, ASL TO3, Regione Piemonte, Grugliasco, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gnavi
mesh_terms: D000208:Acute Disease; D000368:Aged; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005060:Europe; D005260:Female; D006760:Hospitalization; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D054795:Incretins / Q000009:adverse effects* / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010195:Pancreatitis / Q000139:chemically induced* / Q000453:epidemiology; D010351:Patient Discharge; D012307:Risk Factors
chemical_list: D007004:Hypoglycemic Agents; D054795:Incretins