A recent study has found that mimetics do not increase a patient’s risk of pancreatitis, lending further weight to the European Medicines Association’s advice that concerns of pancreatic damage with mimetics is unwarranted.
The systematic review and meta-analysis included 60 studies, featuring 353,639 patients, and consisting of 55 randomised trials and five observational studies. The studies investigated GLP-1 agonists or DPP-4 inhibitors in adults with type 2 diabetes, compared with placebo, lifestyle modification, or active anti-diabetic drugs (e.g. pioglitazone, metformin, glimepiride), in order to assess the risk of pancreatitis with the use of incretin-based treatments in these patients. Follow-up of included studies was for a minimum of 12 weeks.
Analysis of the 55 randomised controlled trials did not suggest a significant increase in risk of pancreatitis with mimetics versus control. Analysis by the type of mimetic suggested similarly non-significant results for GLP-1 agonists versus control, and for DPP-4 inhibitors versus control. In addition, the three retrospective cohort studies featured did not suggest an increased risk of pancreatitis associated with either exenatide or sitagliptin.
The researchers note that the available evidence ‘suggests that the incidence of pancreatitis in patients taking mimetics is low and that these drugs do not increase the risk of pancreatitis’, but advise that the current body of evidence ‘is not definitive, and more carefully designed and conducted studies are warranted to definitively establish the extent – if any – of increased risk’.