Pancreatitis and Pancreatic Cancer Risk Among Patients With Type 2 Diabetes Receiving Dipeptidyl Peptidase 4 Inhibitors: An Updated Meta-Analysis of Randomized Controlled Trials

IF 3.2 4区医学 Q2 PHARMACOLOGY & PHARMACY

Clinical therapeutics Pub Date : 2024-08-01 DOI:10.1016/j.clinthera.2024.06.015

Adili Tuersun MS , Guanxin Hou BS , Gang Cheng PhD

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引用次数: 0

Abstract

Purpose

This meta-analysis sought to assess the relationship between dipeptidyl peptidase-4 inhibitors (DPP-4) and the risk of pancreatitis and pancreatic cancer by synthesizing data from randomized, controlled trials, in light of the conflicting findings from observational studies and previous meta-analyses.

Methods

Cochrane, Embase, ClinicalTrials.gov, and PubMed databases that compared the use of DPP-4 inhibitors and that reported pancreatitis and pancreatic cancer events in patients with diabetes mellitus Type 2 (T2DM) were searched using specific terms. Studies were included if they satisfied the following inclusion criteria: They were randomized trials comparing DPP-4 inhibitors use in patients with T2DM; The study's duration was longer than 24 weeks; And they reported pancreatitis and pancreatic cancer events. Stata 15 MP was used to analyze the data, and odds ratios (OR) with 95% confidence intervals (CI) were used to represent the results.

Findings

A total of 81,737 participants with T2DM were included in the analysis. The results showed that during a mean follow-up period of 24 to 520 weeks, The use of DPP-4 inhibitors was not associated with an increased risk of pancreatitis (Peto-OR 0.97; 95% CI: 0.74, 1.27) or pancreatic cancer (Peto-OR = 0.88; 95% CI: 0.59, 1.30).

Implications

Current evidence fails to validate a significant correlation between DPP-4 therapy and pancreatitis or pancreatic cancer. However, subgroup analyses showed that sitagliptin was associated with a significant reduction in pancreatitis risk compared to the control group; furthermore, when comparing different types of control medications, a significant decrease in pancreatic cancer risk was observed among DPP-4 users compared to GLP-1 users.

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接受二肽基肽酶 4 抑制剂治疗的 2 型糖尿病患者的胰腺炎和胰腺癌风险：随机对照试验的最新 Meta 分析。

目的：本荟萃分析旨在评估二肽基肽酶-4 抑制剂（DPP-4）与胰腺炎和胰腺癌风险之间的关系：方法：使用特定术语检索 Cochrane、Embase、ClinicalTrials.gov 和 PubMed 数据库，这些数据库比较了 DPP-4 抑制剂的使用情况，并报告了 2 型糖尿病 (T2DM) 患者的胰腺炎和胰腺癌事件。符合以下纳入标准的研究均被纳入：它们是比较 DPP-4 抑制剂在 T2DM 患者中使用情况的随机试验；研究持续时间超过 24 周；报告了胰腺炎和胰腺癌事件。使用Stata 15 MP对数据进行分析，并使用几率比（OR）和95%置信区间（CI）来表示结果：共有 81 737 名 T2DM 患者参与了分析。结果显示，在平均 24 至 520 周的随访期间，使用 DPP-4 抑制剂与胰腺炎（Poto-OR 0.97；95% CI：0.74, 1.27）或胰腺癌（Poto-OR = 0.88；95% CI：0.59, 1.30）风险的增加无关：目前的证据未能证实 DPP-4 疗法与胰腺炎或胰腺癌之间存在显著相关性。然而，亚组分析显示，与对照组相比，西格列汀与胰腺炎风险的显著降低有关；此外，在比较不同类型的对照药物时，观察到DPP-4使用者与GLP-1使用者相比，胰腺癌风险显著降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical therapeutics 医学-药学

CiteScore

6.00

自引率

3.10%

发文量

154

审稿时长

9 weeks

期刊介绍： Clinical Therapeutics provides peer-reviewed, rapid publication of recent developments in drug and other therapies as well as in diagnostics, pharmacoeconomics, health policy, treatment outcomes, and innovations in drug and biologics research. In addition Clinical Therapeutics features updates on specific topics collated by expert Topic Editors. Clinical Therapeutics is read by a large international audience of scientists and clinicians in a variety of research, academic, and clinical practice settings. Articles are indexed by all major biomedical abstracting databases.