Use of incretin agents and risk of acute and chronic pancreatitis: A population-based cohort study

Background: Incretins are new therapeutic agents for the treatment of Type 2 Diabetes Mellitus (T2DM), and are a subgroup of the Non-Insulin Antidiabetic Drugs (NIAD). Although incretin agents have demonstrated efficacy for T2DM, they have been associated with pancreatitis. Recent literature shows limited and conflicting evidence for the association between incretin agents and the risk of acute pancreatitis. Furthermore, the risk of chronic pancreatitis with the use of incretin agents has not been investigated. Objectives: To determine the association between the use of incretin agents and the risk of acute and chronic pancreatitis. Methods: A retrospective population based cohort study, using data from the Clinical Practice Research Datalink (CPRD) (2007.2012), was conducted. Patients (N=182,428) with at least one NIAD prescription and aged 18+ during data collection, were matched to one control patient without diabetes. Multivariable Cox proportional hazards models and a new user design were used to estimate the hazard ratio of (acute, chronic and any) pancreatitis in incretin users (N=28,370) compared with non-diabetics and other NIAD-treated patients. Time dependent adjustments were made for age, sex, life style, comorbidities and drug use. Results: Current NIAD use was associated with acute, chronic and any pancreatitis. This risk increased among current incretin users, as compared to non-diabetic controls. However, only any pancreatitis was associated with incretin use when compared to other NIAD-treated patients (HR=1.47, 95% CI 1.06.2.04). Pancreatitis risk was higher among younger patients (age 18-≥59 years), those with a BMI