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Pancreatitis and pancreatic cancer in patients with type 2 diabetes treated with glucagon-like peptide-1 receptor agonists: an updated meta-analysis of randomized controlled trials.
Minerva Endocrinol. 2020 Jul 23 [Online ahead of print]ME

Abstract

AIM

An association between Glucagon-Like Peptide-1 Receptor Agonists (GLP1-RA) and risk of pancreatitis and pancreatic cancer has been suggested. Since its first description, several new trials (including three cardiovascular outcome trials) have been published, substantially increasing the available data set. This suggests the need for an update of the previous meta analysis.

MATERIALS AND METHODS

A Medline search for GLP-1 receptor agonists (exenatide, liraglutide, lixisenatide, albiglutide, dulaglutide, or semaglutide) was performed, collecting all randomized clinical trials, with duration ≥52 weeks, enrolling patients with type 2 diabetes, and comparing a GLP-1 receptor agonist with placebo or any other non-GLP-1 receptor agonist drug. The endpoints were pancreatitis, pancreatic cancer reported as serious adverse events. Mantel-Haenszel odds ratio (MH-OR) with 95% Confidence Interval (95% CI) was calculated for all outcomes defined above, on an intention-to-treat basis.

RESULTS

A total of 43 trials fulfilling inclusion criteria (all reporting data on pancreatitis and pancreatic cancer) was identified. GLP-1 RA showed no association with pancreatitis (MH-OR 1.24 [0.94, 1.64]; p=0,13) and pancreatic cancer (MH-OR 1.28 [0.87, 1.89]; p=0,20).

CONCLUSIONS

No clear evidence of risk for pancreatitis was observed, whereas data on pancreatic cancer are too scarce to draw any conclusion.

Authors+Show Affiliations

Diabetology, Careggi Hospital and University of Florence, Florence, Italy.Diabetology, Careggi Hospital and University of Florence, Florence, Italy.Diabetology, Careggi Hospital and University of Florence, Florence, Italy.Diabetology, Careggi Hospital and University of Florence, Florence, Italy.Diabetology, Careggi Hospital and University of Florence, Florence, Italy - matteo.monami@unifi.it.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32720500

Citation

Nreu, Besmir, et al. "Pancreatitis and Pancreatic Cancer in Patients With Type 2 Diabetes Treated With Glucagon-like Peptide-1 Receptor Agonists: an Updated Meta-analysis of Randomized Controlled Trials." Minerva Endocrinologica, 2020.
Nreu B, Dicembrini I, Tinti F, et al. Pancreatitis and pancreatic cancer in patients with type 2 diabetes treated with glucagon-like peptide-1 receptor agonists: an updated meta-analysis of randomized controlled trials. Minerva Endocrinol. 2020.
Nreu, B., Dicembrini, I., Tinti, F., Mannucci, E., & Monami, M. (2020). Pancreatitis and pancreatic cancer in patients with type 2 diabetes treated with glucagon-like peptide-1 receptor agonists: an updated meta-analysis of randomized controlled trials. Minerva Endocrinologica. https://doi.org/10.23736/S0391-1977.20.03219-8
Nreu B, et al. Pancreatitis and Pancreatic Cancer in Patients With Type 2 Diabetes Treated With Glucagon-like Peptide-1 Receptor Agonists: an Updated Meta-analysis of Randomized Controlled Trials. Minerva Endocrinol. 2020 Jul 23; PubMed PMID: 32720500.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pancreatitis and pancreatic cancer in patients with type 2 diabetes treated with glucagon-like peptide-1 receptor agonists: an updated meta-analysis of randomized controlled trials. AU - Nreu,Besmir, AU - Dicembrini,Ilaria, AU - Tinti,Federico, AU - Mannucci,Edoardo, AU - Monami,Matteo, Y1 - 2020/07/23/ PY - 2020/7/29/entrez JF - Minerva endocrinologica JO - Minerva Endocrinol. N2 - AIM: An association between Glucagon-Like Peptide-1 Receptor Agonists (GLP1-RA) and risk of pancreatitis and pancreatic cancer has been suggested. Since its first description, several new trials (including three cardiovascular outcome trials) have been published, substantially increasing the available data set. This suggests the need for an update of the previous meta analysis. MATERIALS AND METHODS: A Medline search for GLP-1 receptor agonists (exenatide, liraglutide, lixisenatide, albiglutide, dulaglutide, or semaglutide) was performed, collecting all randomized clinical trials, with duration ≥52 weeks, enrolling patients with type 2 diabetes, and comparing a GLP-1 receptor agonist with placebo or any other non-GLP-1 receptor agonist drug. The endpoints were pancreatitis, pancreatic cancer reported as serious adverse events. Mantel-Haenszel odds ratio (MH-OR) with 95% Confidence Interval (95% CI) was calculated for all outcomes defined above, on an intention-to-treat basis. RESULTS: A total of 43 trials fulfilling inclusion criteria (all reporting data on pancreatitis and pancreatic cancer) was identified. GLP-1 RA showed no association with pancreatitis (MH-OR 1.24 [0.94, 1.64]; p=0,13) and pancreatic cancer (MH-OR 1.28 [0.87, 1.89]; p=0,20). CONCLUSIONS: No clear evidence of risk for pancreatitis was observed, whereas data on pancreatic cancer are too scarce to draw any conclusion. SN - 1827-1634 UR - https://www.unboundmedicine.com/medline/citation/32720500/Pancreatitis_and_pancreatic_cancer_in_patients_with_type_2_diabetes_treated_with_glucagon_like_peptide_1_receptor_agonists:_an_updated_meta_analysis_of_randomized_controlled_trials_ L2 - https://www.minervamedica.it/index2.t?show=R07Y9999N00A20072305 DB - PRIME DP - Unbound Medicine ER -
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