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. 2024 Sep;18(9):103116.
doi: 10.1016/j.dsx.2024.103116. Epub 2024 Sep 19.

Decreased risk of recurrent acute pancreatitis with semaglutide and tirzepatide in people with type 2 diabetes or obesity with a history of acute pancreatitis: A propensity matched global federated TriNetX database-based retrospective cohort study

Mahmoud Nassar  1 , Omar Nassar  2 , Hazem Abosheaishaa  3 , Anoop Misra  4
Affiliations

Decreased risk of recurrent acute pancreatitis with semaglutide and tirzepatide in people with type 2 diabetes or obesity with a history of acute pancreatitis: A propensity matched global federated TriNetX database-based retrospective cohort study

Mahmoud Nassar et al. Diabetes Metab Syndr. 2024 Sep.

Abstract

Background: Acute pancreatitis (AP) is a significant health concern with potential for recurrent episodes and serious complications. The risk of recurrence in type 2 diabetes (T2D) or obesity can be influenced by various factors and treatments, including GLP-1 receptor agonists (GLP-1RAs). This study evaluates the risk of recurrent AP among patients with a history of the condition, focusing on the effects of different GLP-1RA treatments.

Objectives: Our objective is to compare the recurrence risks of AP between patients treated with different GLP-1RAs.

Methods: We conducted a retrospective cohort study using the TriNetX platform, encompassing 258,238 individuals with T2D or obesity who have a history of AP. We assessed the recurrence of AP over a five-year period, analyzing data on treatment regimens, with a focus on the use of Semaglutide, Tirzepatide, and other GLP-1RAs.

Results: GLP-1RA users experienced significantly lower recurrence rates of AP, with those without risk factors showing GLP-1RA users had a recurrence rate of 13.8 % compared to 40.9 % for non-users. Semaglutide and Tirzepatide showed the most favorable outcomes; Semaglutide users had lower recurrence rates than Exenatide (10.1 % vs. 27 %) and slightly lower than Dulaglutide (13.6 % vs. 15.4 %), though not statistically significant with Dulaglutide. Tirzepatide users displayed the lowest recurrence risk at 6.2 %, significantly lower than those on Semaglutide (11.7 %).

Conclusions: GLP-1RAs, particularly Semaglutide and Tirzepatide, are associated with a reduced risk of recurrent AP in people with T2D or obesity. The differential risk profile between these drugs highlights the need for further studies and personalized treatment plans.

Keywords: Acute pancreatitis; GLP-1 receptor agonists; Recurrence risk; Retrospective cohort study; Semaglutide; Tirzepatide; TriNetX.

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Conflict of interest statement

Declaration of competing interest and Funding The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper. No funding was required for this study.

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