Liraglutide use and evaluation of pancreatic outcomes in a US commercially insured population

Abstract

Aims Both acute pancreatitis (AP) and pancreatic cancer (PC) have been areas of focus for studies of incretin drugs. This 5‐year prospective cohort study aimed to quantify possible associations between liraglutide and risk of AP and PC as compared to other antidiabetic drugs (ADs). Materials and methods Patients initiating liraglutide or other ADs who were enrolled in a US health plan (2010‐2014) were included. Comparisons of AP and PC incidence rates were made between matched cohorts of liraglutide initiators and initiators of other ADs. Adjudicated AP cases and algorithm‐based PC cases were identified. Propensity score‐matched intention‐to‐treat (ITT) and time‐on‐drug (TOD) analyses were completed using Poisson regression. A latency analysis was performed for PC. Results Median follow‐up was 405 days for AP cohorts (9995 liraglutide, 1:1 matched to all comparators) and 503 days for PC cohorts (35 163 liraglutide, 1:1 matched to all comparators). In the primary AP analysis, “current” use of liraglutide was not significantly associated with elevated risk across comparators (all comparators relative risk [RR] = 1.2; 95% confidence interval [CI], 0.6‐2.3). ITT results were similar where, in the primary analysis, no RRs were significantly associated with PC (all comparators RR = 0.7; 95% CI, 0.3‐1.4); latency and TOD analyses did not alter findings. There was no evidence of a dose‐response effect. Conclusions Liraglutide was not associated with an increased risk of AP or PC, although risk estimates were more variable for AP, and numbers of cases for both outcomes were limited because of the rarity of outcomes.

Glucagon-Like Peptide 1 Receptor Agonist (GLP1RA) Exposure and Outcomes in Type 2 Diabetes: A Systematic Review of Population-Based Observational Studies

“…We found 22 studies in total of which 12 were commercially funded [13][14][15][16][17][18][19][20][21][22][23][24][25] and 10 were funded by academic/non-profit/government organisations [26][27][28][29][30][31][32][33][34][35]. Six studies were identified through reference searching.…”

A Diabetic Patient Complicated With Pancreatic Cancer After Using Liraglutide: A Case Report

“…However, Funch et al. found that median days from the initiation of liraglutide to the pancreatic cancer diagnosis were 369 (interquartile range, 226–1,099) ( 19 ), and Knapen et al. found that the risk of pancreatic cancer almost doubled in those who had recently initiated GLP-1 analogs therapy ( 20 ), which makes the time interval of 20 months plausible.…”

Mildly symptomatic liraglutide-induced acute pancreatitis in a patient with type 2 diabetes mellitus: a case report

“…The absence of pain represents a serious clinical challenge with probable missed diagnosis of AP. Funch et al [7] found that liraglutide was not associated with an increased risk of AP, but they reported concerns regarding the limited numbers, rarity of outcomes, and unmeasured confounding factors and ethnicity issue. The US Food and Drug Administration (FDA) and European Medicine Agency reviewed the existing data about GLP1-RA, and till now, they did not get a final conclusion regarding a causal relationship between GLP1-RA and AP; therefore, they keep safety risks for these drugs.…”