Diabetes therapies and pancreatitis risk

Glucagonlike peptide 1 (GLP-1) mimetics (e.g., analogs of GLP-1 and dipeptidyl peptidase IV inhibitors) used for the treatment of type 2 diabetes might increase the risk of pancreatitis, according to a recent population-based, case-control study. Using a large population database of type 2 diabetics, 1269 cases of acute pancreatitis were identified and those patients were matched with 1269 controls with similar risk factors (age, sex, diabetes mellitus complications, etc). After adjusting for available confounders, current use of GLP-1 based therapies (exenatide [Byetta] and sitagliptin [Januvia]) more than doubled the risk for acute pancreatitis (adjusted odds ratio 2.24, 95% CI, 1.36-3.68). The authors state that "Our findings suggest a significantly increased risk of hospitalization for acute pancreatitis associated with the use of sitagliptin or exenatide among adult patients with type 2 diabetes mellitus" (JAMA Intern Med published online Feb. 25, 2013. DOI: 10.1001/jamainternmed.2013.2720). Both drugs already carry a boxed warning regarding pancreatitis.