アブストラクト | AIM: To determine the association between the use of incretin agents (dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists) for the treatment of type 2 diabetes mellitus (T2DM) and the risk of any, acute and chronic pancreatitis. RESEARCH DESIGN AND METHODS: A population-based cohort study was conducted using data from the UK Clinical Practice Research Datalink (CPRD 2007-2012). A total of 182 428 adult patients with >/=1 non-insulin antidiabetic drug (NIAD) prescription were matched to control subjects without diabetes. Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of pancreatitis in incretin-users (N = 28 370) compared with controls and with other NIAD users. Adjustments were made for lifestyle, disease and drug history. In a sensitivity analysis, a new-user design was used. RESULTS: Current incretin users had a 1.5-fold increased risk of any pancreatitis compared with NIAD users (adjusted HR 1.47, 95% CI 1.06-2.04). In incident current incretin users the risk of any and acute pancreatitis was increased 2.1- and 2.0-fold compared with NIAD users (adjusted HR 2.12, 95% CI 1.31-3.43 and adjusted HR 1.96, 95% CI 1.13-3.41), whereas there was no increased risk found for chronic pancreatitis. CONCLUSIONS: Incretin use was associated with an increased risk of any pancreatitis. Moreover, risk of any and acute pancreatitis was higher when applying a new-user design. We were not able to detect an association with chronic pancreatitis, but the number in this subgroup was small. |
ジャーナル名 | Diabetes, obesity & metabolism |
投稿日 | 2016/11/25 |
投稿者 | Knapen, Lotte M; de Jong, Roy G P J; Driessen, Johanna H M; Keulemans, Yolande C; van Erp, Nielka P; De Bruin, Marie L; Leufkens, Hubert G M; Croes, Sander; de Vries, Frank |
組織名 | Department of Clinical Pharmacy and Toxicology, Maastricht University Medical;Centre+, Maastricht, The Netherlands.;CAPHRI Care and Public Health Research Institute, Maastricht University Medical;Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands.;GROW School for Oncology and Developmental Biology, Maastricht University Medical;Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute;for Pharmaceutical Sciences, Utrecht, The Netherlands.;Department of Gastroenterology, Zuyderland Medical Centre, Heerlen, The;Netherlands.;Department of Pharmacy, Radboud University Medical Centre, Nijmegen, The;MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of;Southampton, Southampton, UK. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/27883260/ |