Risk of Pancreatitis With Incretin Therapies Versus Thiazolidinediones in the Veterans Health Administration.

Publisher: Sage Country of Publication: United States NLM ID: 9203131 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1542-6270 (Electronic) Linking ISSN: 10600280 NLM ISO Abbreviation: Ann Pharmacother Subsets: MEDLINE

Publication: Sept. 2013- : Thousand Oaks, CA : Sage
Original Publication: Cincinnati, OH : Harvey Whitney Books Co., c1992-

Pancreatitis*/chemically induced ; Pancreatitis*/epidemiology ; Diabetes Mellitus, Type 2*/drug therapy ; Diabetes Mellitus, Type 2*/epidemiology ; Thiazolidinediones*/adverse effects ; Thiazolidinediones*/therapeutic use ; Incretins*/adverse effects ; Incretins*/therapeutic use ; Hypoglycemic Agents*/adverse effects ; Hypoglycemic Agents*/administration & dosage ; United States Department of Veterans Affairs*/statistics & numerical data; Humans ; Retrospective Studies ; Male ; Middle Aged ; Female ; United States/epidemiology ; Aged ; Dipeptidyl-Peptidase IV Inhibitors/adverse effects ; Dipeptidyl-Peptidase IV Inhibitors/therapeutic use ; Dipeptidyl-Peptidase IV Inhibitors/administration & dosage ; Glucagon-Like Peptide-1 Receptor/agonists ; Cohort Studies ; Pioglitazone/adverse effects ; Pioglitazone/therapeutic use ; Veterans ; Rosiglitazone/adverse effects

Background: Incretin therapies, comprised of the dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), have been increasingly utilized for the treatment of type 2 diabetes (T2DM). Previous studies have conflicting results regarding risk of pancreatitis associated with these agents-some suggest an increased risk and others find no correlation. Adverse event reporting systems indicate that incretin therapies are some of the most common drugs associated with reports of pancreatitis.
Objectives: This study aimed to compare the odds of developing pancreatitis in veterans with T2DM prescribed an incretin therapy versus thiazolidinediones (TZDs: pioglitazone and rosiglitazone) within the Veterans Health Administration (VHA).
Methods: This was a retrospective cohort study analyzing veterans with T2DM first prescribed an incretin therapy or a TZD between January 1, 2011, and December 31, 2021. A diagnosis of pancreatitis within 365 days of being prescribed either therapy was counted as a positive case. Data was collected and analyzed utilizing VA's Informatics and Computing Infrastructure (VINCI) and an adjusted odds ratio was calculated.
Results: The TZD cohort consisted of 42 912 patients compared with the incretin cohort of 304 811 patients. The TZD cohort had a pancreatitis incidence rate of 1.94 cases per 1000 patients. The incretin cohort had a incidence rate of 2.06 cases per 1000 patients. An adjusted odds ratio found no statistical difference of pancreatitis cases between the TZD and incretin cohorts (adjusted odds ratio [AOR] = 0.94, 95% CI [0.75, 1.18]).
Conclusion and Relevance: This retrospective cohort study of national VHA data found a relatively low incidence of pancreatitis in both cohorts, and an adjusted odds ratio found no statistical difference of pancreatitis in patients prescribed an incretin therapy compared with a control group. This data adds to growing evidence that incretin therapies do not seem to be associated with an increased risk of developing pancreatitis.
Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Keywords: diabetes; dipeptidyl peptidase-4 inhibitor; glucagon-like peptide 1 agonist; incretin; pancreas; pancreatitis; thiazolidinedione; veterans affairs

0 (Thiazolidinediones)
0 (Incretins)
0 (Hypoglycemic Agents)
0 (Dipeptidyl-Peptidase IV Inhibitors)
0 (Glucagon-Like Peptide-1 Receptor)
X4OV71U42S (Pioglitazone)
05V02F2KDG (Rosiglitazone)

Date Created: 20231026 Date Completed: 20240603 Latest Revision: 20240603

20240603

10.1177/10600280231205490

37881914