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Meta-Analysis
. 2020 Jun;68(3):518-525.
doi: 10.1007/s12020-020-02223-6. Epub 2020 Feb 26.

GLP-1 receptor agonists and pancreatic safety concerns in type 2 diabetic patients: data from cardiovascular outcome trials

Chuqing Cao  1   2 , Shuting Yang  1   2 , Zhiguang Zhou  3   4
Affiliations
Meta-Analysis

GLP-1 receptor agonists and pancreatic safety concerns in type 2 diabetic patients: data from cardiovascular outcome trials

Chuqing Cao et al. Endocrine. 2020 Jun.

Abstract

Purpose: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been suggested to be associated with an increased risk of pancreatitis and pancreatic cancer. The aim of this meta-analysis was to collect data from large-scale cardiovascular outcome trials (CVOTs) to assess the effect of GLP-1RAs on the incidence of acute pancreatitis and pancreatic cancer.

Methods: Database of Medline, Embase, and the Cochrane Central Register of Controlled Trials were extensively searched up to October 10, 2019. Randomized controlled trials were eligible if they compared GLP-RA with placebo as add-on therapy to standard care in T2DM patients, and reported outcomes required for cardiovascular safety studies and events of acute pancreatitis and/or pancreatic cancer. Peto odds ratio (OR) with 95% confidence interval (CI) was calculated for acute pancreatitis and pancreatic cancer.

Results: Seven CVOTs enrolling 56,004 patients with T2DM were identified, with a median follow-up time ranging from 1.3 to 5.4 years. A total of 180 cases of acute pancreatitis and 108 cases of pancreatic cancer were reported. The risk of either acute pancreatitis or pancreatic cancer with GLP-1-RA treatment was not significantly different from that observed in placebo arm (Peto OR [95% CI] 1.05 [0.78-1.40], P = 0.76, and 1.12 [0.77-1.63], P = 0.56, respectively), and the results remained robust to sensitivity analyses.

Conclusion: Pooled analysis of CVOTs did not suggest any increased risk of either acute pancreatitis or pancreatic cancer with GLP-1RA treatment in T2DM patients.

Keywords: GLP-1 receptor agonist; Meta-analysis; Pancreatic cancer; Pancreatitis; Type 2 diabetes mellitus.

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