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25-02-2013 | Article

GLP-1 pancreatitis concerns flagged

Abstract

JAMA Intern Med 2013; Advance online publication

Study results have raised further concerns over a link between pancreatitis and the use of glucagon-like peptide-1 (GLP-1)-based therapies for type 2 diabetes.

The findings, published in JAMA Internal Medicine, showed that patients taking sitagliptin and exenatide had double the risk of hospital admission for acute pancreatitis compared with type 2 diabetes patients not taking these drugs.

The study included 1269 patients admitted to hospital with acute pancreatitis and 1269 control patients closely matched or age, sex, diabetes complications and enrollment patterns.

Dr Sonal Singh (John Hopkins University, Baltimore, Maryland, USA) and colleagues report that patients who were hospitalised with acute pancreatitis were more likely than controls to have hypertriglyceridaemia, alcohol use, gallstones, tobacco abuse, obesity, biliary and pancreatic cancer, and cystic fibrosis. However, after controlling for these factors, as well as metformin use, GLP-1 therapy use within the previous 30 days was still associated with a 2.24-fold increase in the odds of hospital admission for acute pancreatitis. Use earlier than in the past 30 days but in the prior 2 years was also associated with a 2.01-fold increase in the odds of admission.

Since its launch in 2006, there have been repeated reports of acute pancreatitis among patients taking exenatide, and rodent models have supported the association. The UK drugs regulator MHRA previously issued guidance that exenatide use should be immediately discontinued if pancreatitis is suspected.

In a related commentary, Drs Belinda Gier and Peter Butler of the University of California, Los Angeles, USA, say that the findings are a warning that the drugs still have unknown effects, particularly on the risk of pancreatic cancer. "Singh and colleagues provide a timely reminder that, despite large numbers of underpowered studies claiming the contrary from marketing companies, little is yet known about long-term adverse effects of the GLP-1 class of drugs on the exocrine pancreas," they caution.

Medical News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Kirsty Oswald, medwireNews Reporter