Risk of Pancreatitis With Incretin Therapies Versus Thiazolidinediones in the Veterans Health Administration
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...
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| Veröffentlicht in: | The Annals of pharmacotherapy 2024-07, Vol.58 (7), p.685-689 |
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| container_title | The Annals of pharmacotherapy |
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| creator | Wilhite, Kristen Reid, Jennifer Meyer Lane, Matthew |
| description | 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. |
| doi_str_mv | 10.1177/10600280231205490 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2882325742</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_10600280231205490</sage_id><sourcerecordid>2882325742</sourcerecordid><originalsourceid>FETCH-LOGICAL-c292t-ce4222c981d9b98b68af7adb46d49561652653dd0d3538285828f50da00aa7303</originalsourceid><addsrcrecordid>eNp9kE1LAzEQhoMoWqs_wIvs0cvqZHazmxyl-AUFRfw4Lukma1O3SU2yB_31prR6ETwMGWaeeSAvIScUzimt6wsKFQBywIIisFLADhlRVmJeYQ27qU_7fA0ckMMQFgAgKIp9clDUnFNByxHpH014z1yXPUjbei2jiSZkrybOs7v1IBqbPc21lyujQ_aifRhCGhj55XqjjNXKOJs2CYtznYCYWBuyWy375LhUS2NNiD6JnT0ie53sgz7evmPyfH31NLnNp_c3d5PLad6iwJi3ukTEVnCqxEzwWcVlV0s1KytVClbRimHFCqVAFazgyFmqjoGSAFLWBRRjcrbxrrz7GHSIzdKEVve9tNoNoUHOsUBWl5hQukFb70LwumtW3iyl_2woNOuQmz8hp5vTrX6YLbX6vfhJNQHnGyDIN90s3OBt-u4_xm-7yoRx</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2882325742</pqid></control><display><type>article</type><title>Risk of Pancreatitis With Incretin Therapies Versus Thiazolidinediones in the Veterans Health Administration</title><source>MEDLINE</source><source>SAGE Complete</source><creator>Wilhite, Kristen ; Reid, Jennifer Meyer ; Lane, Matthew</creator><creatorcontrib>Wilhite, Kristen ; Reid, Jennifer Meyer ; Lane, Matthew</creatorcontrib><description>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.</description><identifier>ISSN: 1060-0280</identifier><identifier>EISSN: 1542-6270</identifier><identifier>DOI: 10.1177/10600280231205490</identifier><identifier>PMID: 37881914</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Cohort Studies ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - epidemiology ; Dipeptidyl-Peptidase IV Inhibitors - administration & dosage ; Dipeptidyl-Peptidase IV Inhibitors - adverse effects ; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use ; Female ; Glucagon-Like Peptide-1 Receptor - agonists ; Humans ; Hypoglycemic Agents - administration & dosage ; Hypoglycemic Agents - adverse effects ; Incretins - adverse effects ; Incretins - therapeutic use ; Male ; Middle Aged ; Pancreatitis - chemically induced ; Pancreatitis - epidemiology ; Pioglitazone - adverse effects ; Pioglitazone - therapeutic use ; Retrospective Studies ; Rosiglitazone - adverse effects ; Thiazolidinediones - adverse effects ; Thiazolidinediones - therapeutic use ; United States - epidemiology ; United States Department of Veterans Affairs - statistics & numerical data ; Veterans</subject><ispartof>The Annals of pharmacotherapy, 2024-07, Vol.58 (7), p.685-689</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c292t-ce4222c981d9b98b68af7adb46d49561652653dd0d3538285828f50da00aa7303</cites><orcidid>0000-0003-1550-6509</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/10600280231205490$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/10600280231205490$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37881914$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilhite, Kristen</creatorcontrib><creatorcontrib>Reid, Jennifer Meyer</creatorcontrib><creatorcontrib>Lane, Matthew</creatorcontrib><title>Risk of Pancreatitis With Incretin Therapies Versus Thiazolidinediones in the Veterans Health Administration</title><title>The Annals of pharmacotherapy</title><addtitle>Ann Pharmacother</addtitle><description>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.</description><subject>Aged</subject><subject>Cohort Studies</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Dipeptidyl-Peptidase IV Inhibitors - administration & dosage</subject><subject>Dipeptidyl-Peptidase IV Inhibitors - adverse effects</subject><subject>Dipeptidyl-Peptidase IV Inhibitors - therapeutic use</subject><subject>Female</subject><subject>Glucagon-Like Peptide-1 Receptor - agonists</subject><subject>Humans</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Hypoglycemic Agents - adverse effects</subject><subject>Incretins - adverse effects</subject><subject>Incretins - therapeutic use</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pancreatitis - chemically induced</subject><subject>Pancreatitis - epidemiology</subject><subject>Pioglitazone - adverse effects</subject><subject>Pioglitazone - therapeutic use</subject><subject>Retrospective Studies</subject><subject>Rosiglitazone - adverse effects</subject><subject>Thiazolidinediones - adverse effects</subject><subject>Thiazolidinediones - therapeutic use</subject><subject>United States - epidemiology</subject><subject>United States Department of Veterans Affairs - statistics & numerical data</subject><subject>Veterans</subject><issn>1060-0280</issn><issn>1542-6270</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMoWqs_wIvs0cvqZHazmxyl-AUFRfw4Lukma1O3SU2yB_31prR6ETwMGWaeeSAvIScUzimt6wsKFQBywIIisFLADhlRVmJeYQ27qU_7fA0ckMMQFgAgKIp9clDUnFNByxHpH014z1yXPUjbei2jiSZkrybOs7v1IBqbPc21lyujQ_aifRhCGhj55XqjjNXKOJs2CYtznYCYWBuyWy375LhUS2NNiD6JnT0ie53sgz7evmPyfH31NLnNp_c3d5PLad6iwJi3ukTEVnCqxEzwWcVlV0s1KytVClbRimHFCqVAFazgyFmqjoGSAFLWBRRjcrbxrrz7GHSIzdKEVve9tNoNoUHOsUBWl5hQukFb70LwumtW3iyl_2woNOuQmz8hp5vTrX6YLbX6vfhJNQHnGyDIN90s3OBt-u4_xm-7yoRx</recordid><startdate>20240701</startdate><enddate>20240701</enddate><creator>Wilhite, Kristen</creator><creator>Reid, Jennifer Meyer</creator><creator>Lane, Matthew</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1550-6509</orcidid></search><sort><creationdate>20240701</creationdate><title>Risk of Pancreatitis With Incretin Therapies Versus Thiazolidinediones in the Veterans Health Administration</title><author>Wilhite, Kristen ; Reid, Jennifer Meyer ; Lane, Matthew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c292t-ce4222c981d9b98b68af7adb46d49561652653dd0d3538285828f50da00aa7303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Cohort Studies</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Dipeptidyl-Peptidase IV Inhibitors - administration & dosage</topic><topic>Dipeptidyl-Peptidase IV Inhibitors - adverse effects</topic><topic>Dipeptidyl-Peptidase IV Inhibitors - therapeutic use</topic><topic>Female</topic><topic>Glucagon-Like Peptide-1 Receptor - agonists</topic><topic>Humans</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Hypoglycemic Agents - adverse effects</topic><topic>Incretins - adverse effects</topic><topic>Incretins - therapeutic use</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pancreatitis - chemically induced</topic><topic>Pancreatitis - epidemiology</topic><topic>Pioglitazone - adverse effects</topic><topic>Pioglitazone - therapeutic use</topic><topic>Retrospective Studies</topic><topic>Rosiglitazone - adverse effects</topic><topic>Thiazolidinediones - adverse effects</topic><topic>Thiazolidinediones - therapeutic use</topic><topic>United States - epidemiology</topic><topic>United States Department of Veterans Affairs - statistics & numerical data</topic><topic>Veterans</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wilhite, Kristen</creatorcontrib><creatorcontrib>Reid, Jennifer Meyer</creatorcontrib><creatorcontrib>Lane, Matthew</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wilhite, Kristen</au><au>Reid, Jennifer Meyer</au><au>Lane, Matthew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of Pancreatitis With Incretin Therapies Versus Thiazolidinediones in the Veterans Health Administration</atitle><jtitle>The Annals of pharmacotherapy</jtitle><addtitle>Ann Pharmacother</addtitle><date>2024-07-01</date><risdate>2024</risdate><volume>58</volume><issue>7</issue><spage>685</spage><epage>689</epage><pages>685-689</pages><issn>1060-0280</issn><eissn>1542-6270</eissn><abstract>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.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>37881914</pmid><doi>10.1177/10600280231205490</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-1550-6509</orcidid></addata></record> |
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| ispartof | The Annals of pharmacotherapy, 2024-07, Vol.58 (7), p.685-689 |
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| subjects | Aged Cohort Studies Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - epidemiology Dipeptidyl-Peptidase IV Inhibitors - administration & dosage Dipeptidyl-Peptidase IV Inhibitors - adverse effects Dipeptidyl-Peptidase IV Inhibitors - therapeutic use Female Glucagon-Like Peptide-1 Receptor - agonists Humans Hypoglycemic Agents - administration & dosage Hypoglycemic Agents - adverse effects Incretins - adverse effects Incretins - therapeutic use Male Middle Aged Pancreatitis - chemically induced Pancreatitis - epidemiology Pioglitazone - adverse effects Pioglitazone - therapeutic use Retrospective Studies Rosiglitazone - adverse effects Thiazolidinediones - adverse effects Thiazolidinediones - therapeutic use United States - epidemiology United States Department of Veterans Affairs - statistics & numerical data Veterans |
| title | Risk of Pancreatitis With Incretin Therapies Versus Thiazolidinediones in the Veterans Health Administration |
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