PDF(Pubmed)
Abstract：
Background: Pancreatitis is characterized by inflammation of the pancreas and significantly affects quality of life. Less than 5% of pancreatitis cases are drug-induced, but recent evidence suggests a substantial risk associated with glucagon-like peptide-1 receptor agonists (GLP-1 RAs). The aim of this study was to compare the risk of developing pancreatitis between those using GLP-1 RAs and those using sodium-glucose transport protein 2 (SGLT2) inhibitors and dipeptidyl peptidase 4 (DPP-4) inhibitors. Methods: This study was done using the FDA Adverse Event Reporting System (FAERS) database from 2019 to 2021. This database contains information from diverse submissions from healthcare providers, patients, and manufacturers. To ensure fairness and accuracy, the risk of pancreatitis associated with other hypoglycemic agents (SGLT2 inhibitors and DPP-4 inhibitors) was also investigated. Traditional and Bayesian statistical analysis methods were used to identify disproportionate statistics and included the reporting odds ratio (ROR), proportional reporting ratio (PRR), empirical Bayes geometric mean (EBGM), and information component (IC). A drug-adverse-event combination that met the criteria of all four indices was deemed a signal. Results: The analysis of 2,313 pancreatitis reports linked to hypoglycemic agents revealed a predominant association with GLP-1 RA (70.2%) compared to DPP-4 inhibitors (15%) and SGLT2 (14.7%). Most of these reports involved female patients (50.4%), and the highest incidence occurred in those over 50 years old (38.4%). Additionally, 17.7% of the reports were associated with serious events. The ROR was significant for the risk of pancreatitis when using DPP-4 (13.2, 95% confidence interval (CI) 11.84-14.70), while the ROR for GLP-1 was 9.65 (95% CI 9.17-10.16). The EBGM was highest with DPP-4 (12.25), followed by GLP-1 (8.64), while IC was highest with DPP-4 inhibitors (3.61). Liraglutide had the greatest association with pancreatitis among the GLP-1 RAs (ROR: 6.83, 95% CI 6.60-7.07). Conclusion: The findings show that pancreatitis has a strong link with DPP-4 inhibitors and GPL1 agonists, which pose a greater risk. Among the GLP-1 agonist medications, liraglutide has been found to have an association with pancreatitis.
摘要：
背景：胰腺炎的特征是胰腺的炎症，并显着影响生活质量。不到5%的胰腺炎病例是由药物引起的，但最近的证据表明,与胰高血糖素样肽-1受体激动剂(GLP-1RA)相关的风险相当大.这项研究的目的是比较使用GLP-1RA的患者与使用钠-葡萄糖转运蛋白2（SGLT2）抑制剂和二肽基肽酶4（DPP-4）抑制剂的患者发生胰腺炎的风险。方法：本研究使用2019年至2021年的FDA不良事件报告系统（FAERS）数据库进行。该数据库包含来自医疗保健提供者的各种提交的信息，病人,和制造商。为了确保公平和准确，还研究了与其他降血糖药(SGLT2抑制剂和DPP-4抑制剂)相关的胰腺炎风险.使用传统和贝叶斯统计分析方法来识别不成比例的统计数据，并包括报告优势比(ROR)，比例报告比率(PRR)，经验贝叶斯几何平均值(EBGM)，和信息组件(IC)。符合所有四个指标标准的药物-不良事件组合被认为是信号。结果：对与降血糖药相关的2,313例胰腺炎报告的分析显示，与DPP-4抑制剂（15％）和SGLT2（14.7％）相比，GLP-1RA（70.2％）主要相关。这些报告大多数涉及女性患者(50.4%)，发病率最高的是50岁以上人群(38.4%)。此外,17.7%的报告与严重事件相关。使用DPP-4时，ROR对胰腺炎的风险显着（13.2，95％置信区间（CI）11.84-14.70），而GLP-1的ROR为9.65（95%CI9.17-10.16）。EBGM最高的是DPP-4（12.25），其次是GLP-1（8.64），而DPP-4抑制剂的IC最高（3.61）。在GLP-1RA中，利拉鲁肽与胰腺炎的相关性最大（ROR：6.83，95％CI6.60-7.07）。结论：研究结果表明，胰腺炎与DPP-4抑制剂和GPL1激动剂有很强的联系，这构成了更大的风险。在GLP-1激动剂药物中，已发现利拉鲁肽与胰腺炎有关联.
