title: Incretin-based therapy and risk of acute pancreatitis: a nationwide population-based case-control study.
abstract: OBJECTIVE
  To investigate whether the use of incretin-based drugs (GLP-1 receptor agonists and dipeptidyl peptidase 4 [DPP4] inhibitors) is associated with acute pancreatitis.
  
  
  METHODS
  The study was a nationwide population-based case-control study using medical databases in Denmark. Participants were 12,868 patients with a first-time hospitalization for acute pancreatitis between 2005 and 2012 and a population of 128,680 matched control subjects. The main outcome measure was the odds ratio (OR) for acute pancreatitis associated with different antihyperglycemic drugs. We adjusted for history of gallstones, alcoholism, obesity, and other pancreatitis-associated comorbidities and medications.
  
  
  RESULTS
  A total of 89 pancreatitis patients (0.69%) and 684 control subjects (0.53%) were ever users of incretins. The crude OR for acute pancreatitis among incretin users was 1.36 (95% CI 1.08-1.69), while it was 1.44 (95% CI 1.34-1.54) among users of other antihyperglycemic drugs. After confounder adjustment, the risk of acute pancreatitis was not increased among incretin users (OR 0.95 [95% CI 0.75-1.21]), including DPP4 inhibitor users (OR 1.04 [95% CI 0.80-1.37]) or GLP-1 receptor agonist users (OR 0.82 [95% CI 0.54-1.23]), or among nonincretin antihyperglycemic drug users (OR 1.05 [95% CI 0.98-1.13]), compared with nonusers of any antihyperglycemic drugs. Findings were similar in current versus ever drug users and in patients with pancreatitis risk factors. The adjusted OR comparing incretin-based therapy with other antihyperglycemic therapy internally while also adjusting for diabetes duration and complications was 0.97 (95% CI 0.76-1.23).
  
  
  CONCLUSIONS
  Our findings suggest that the use of incretin-based drugs appears not to be associated with an increased risk of acute pancreatitis.
authors: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark rwt@dce.au.dk.
authors: Reimar Wernich
authors: RW
authors: Thomsen
authors: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Lars
authors: L
authors: Pedersen
authors: Medical Department M (Endocrinology and Diabetes) and Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Niels
authors: N
authors: Møller
authors: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Johnny
authors: J
authors: Kahlert
authors: The Danish Centre for Strategic Research in Type 2 Diabetes, Diabetes Research Centre, Department of Endocrinology, Odense University Hospital, Odense, Denmark.
authors: Henning
authors: H
authors: Beck-Nielsen
authors: Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors: Henrik Toft
authors: HT
authors: Sørensen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D016208:Databases, Factual; D003718:Denmark; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000009:adverse effects*; D004812:Epidemiologic Methods; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000037:antagonists & inhibitors*; D006760:Hospitalization; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D054795:Incretins / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced*; D055815:Young Adult
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D054795:Incretins; D052216:Glucagon-Like Peptide 1