Risk of pancreatic adverse events associated with the use of glucagon-like peptide-1 receptor agonist and dipeptidyl peptidase-4 inhibitor drugs: A systematic review and metaanalysis of randomized trials  

作　　者：Hasan M Shihab Tokunbo Akande Kacie Armstrong Sonal Singh Yoon K Loke 

机构地区：[1]Division of Acute Care Surgery, Johns Hopkins University School of Medicine [2]Department of Pediatrics, Bronx-Lebanon Hospital Center [3]Division of General Internal Medicine, Johns Hopkins University School of Medicine [4]Norwich Medical School, University of East Anglia

出　　处：《World Journal of Meta-Analysis》2015年第6期254-283,共30页世界荟萃分析杂志

摘　　要：AIM: To systematically assess risk of pancreatic adverse events with glucagon-like peptide-1(GLP-1) receptor agonist and dipeptidyl peptidase-4(DPP-4) inhibitor drugs.METHODS: We searched Pub Med, Embase, CINAHL, Cochrane review of clinical trials, pharmaceutical company clinical trials register, United States Food and Drug Administration website, European Medicines Agency website and Clinical Trials.gov for randomized controlled trials from inception to October 2013. Randomized control trial studies were selected for inclusion if they reported on pancreatic complication events and/or changes in pancreatic enzyme levels(serum amylase and serum lipase) as adverse events or as serious adverse events for patients who were on GLP-1 receptor agonist and DPP-4 inhibitor drugs. Two independent reviewers extracted data directly. We performed Peto odds ratio(OR) fixed effect meta-analysis of pancreatic adverse events a, and assessed heterogeneity with the I^2 statistic.RESULTS: Sixty-eight randomized controlled trials were eligible. A total of 60720 patients were included in our analysis of the association of risk of pancreatic complication events with GLP-1 agents. A total of 89 pancreatic related adverse events occurred among the GLP-1 agents compared to 74 events among the controls. There was a statistically significant increased risk of elevation of pancreatic enzymes associated with GLP-1 agents compared with control(Peto OR = 3.15, 95%CI: 1.56-6.39, P = 0.001, I2 = 0%). There was no statistically significant difference in the risk of pancreatic adverse event associated with GLP-1 agent compared with controls(Peto OR = 1.00, 95%CI: 0.73-1.37, P = 1.00, I2 = 0%). There were a total of 71 pancreatitis events in patients on GLP-1 agents and 56 pancreatitis events occurred in the control patients. There were 36 reports of pancreatic cancer in these studies. Of these cases, 2 used linagliptin, 2 used alogliptin, 1 used vildagliptin, 7 used saxagliptin while 6 used sitagliptin. The remaining 18 cases occurred among controlAIM： To systematically assess risk of pancreatic adverse events with glucagon-like peptide-1 （GLP-1） receptor agonist and dipeptidyl peptidase-4 （DPP-4） inhibitor drugs.METHODS： We searched PubMed, Embase, CINAHL, Cochrane review of clinical trials, pharmaceutical com-pany clinical trials register, United States Food and Drug Administration website, European Medicines Agency website and ClinicalTrials.gov for randomized controlled trials from inception to October 2013. Randomized control trial studies were selected for inclusion if they reported on pancreatic complication events and/or changes in pancreatic enzyme levels （serum amylase and serum lipase） as adverse events or as serious adverse events for patients who were on GLP-1 receptor agonist and DPP-4 inhibitor drugs. Two independent reviewers extracted data directly. We performed Peto odds ratio （OR） fxed effect meta-analysis of pancreatic adverse events a, and assessed heterogeneity with the I2 statistic.RESULTS： Sixty-eight randomized controlled trials were eligible. A total of 60720 patients were included in our analysis of the association of risk of pancreatic complication events with GLP-1 agents. A total of 89 pancreatic related adverse events occurred among the GLP-1 agents compared to 74 events among the controls. There was a statistically significant increased risk of elevation of pancreatic enzymes associated with GLP-1 agents compared with control （Peto OR = 3.15, 95%CI： 1.56-6.39, P = 0.001, I2 = 0%）. There was no statistically signifcant difference in the risk of pancreatic adverse event associated with GLP-1 agent compared with controls （Peto OR = 1.00, 95%CI： 0.73-1.37, P = 1.00, I2 = 0%）. There were a total of 71 pancreatitis events in patients on GLP-1 agents and 56 pancreatitis events occurred in the control patients. There were 36 reports of pancreatic cancer in these studies. Of these cases, 2 used linagliptin, 2 used alogliptin, 1 used vilda-gliptin, 7 used saxagliptin while 6 used sitagliptin. The rema

关 键 词：Diabetes MELLITUS PANCREATITIS Glucagon-like peptide-1 AGONISTS Dipeptidyl peptidase-4 inhibitors Meta-analysis 

分 类 号：R1[医药卫生—公共卫生与预防医学]