Use of glucagon-like peptide-1 receptor agonists in people with history of acute pancreatitis: TriNetX analysis

Jan 18, 2025Diabetes & metabolism

Use of diabetes drugs acting on GLP-1 receptors in people with past sudden pancreas inflammation

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Abstract

Analysis of 672,069 patients with a history of acute pancreatitis revealed a significant risk reduction of 0.071 in recurrence for GLP-1 receptor agonists compared to SGLT2 inhibitors over one year.

GLP-1 receptor agonists are associated with a lower risk of acute pancreatitis recurrence compared to SGLT2 inhibitors and DPP-4 inhibitors.
The risk reduction observed with GLP-1 receptor agonists increased from -0.071 at one year to -0.086 by the fifth year compared to SGLT2 inhibitors.
A similar trend was noted for DPP-4 inhibitors, with risk reductions of -0.064 at one year and -0.094 at five years.
These findings suggest that GLP-1 receptor agonists may be a safer treatment option for patients with a history of acute pancreatitis.

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INTRODUCTION: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used in subjects with type 2 diabetes (T2D) and obesity. However, concerns over their association with acute pancreatitis (AP) have emerged. Our aim was to evaluate the risk of recurrence of AP in subjects on GLP-1RAs with a history of AP.

METHODS: This retrospective study deployed the TriNetX platform. We identified adult cohorts of subjects with a history of AP and analyzed the impact of individual medications (GLP-1RAs, SGLT2i, or DPP4i) on the risk of recurrence of AP. To adjust for baseline differences, propensity score matching was done in cohorts with and without risk factors for AP.

RESULTS: Our analysis of 672,069 patients with a history of AP and T2D revealed significant risk reductions associated with GLP-1RAs compared to other treatments. Over one to five years, GLP-1RAs consistently showed a lower risk of AP recurrence compared to SGLT2i and DPP-4i. Specifically, over a one-year period, GLP-1RAs users had a risk reduction of -0.071 (95 % CI:0.085 to -0.057) (p < 0.001) compared to SGLT2i, and -0.064 (95 % CI:0.080 to -0.048) (p< 0.001) compared to DPP-4i. These trends persisted, with the risk differences further widening by the fifth year to -0.086 and -0.094, respectively.

CONCLUSION: Based on our findings, we conclude that GLP-1RAs may be safely used in subjects with a history of acute pancreatitis. While our analysis showed that there was a significantly lower risk of AP recurrence in subjects on GLP-1compared to DPP-IV inhibitors and SGLT2 inhibitors, as this is a retrospective analysis we suggest that these findings need to be confirmed in prospective studies.

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Use of glucagon-like peptide-1 receptor agonists in people with history of acute pancreatitis: TriNetX analysis

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