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Liraglutide Use and Evaluation of Pancreatic Outcomes in a US Commercially Insured Population.
Diabetes, Obesity & Metabolism 2019 April 5
AIMS: Both acute pancreatitis (AP) and pancreatic cancer (PC) have been areas of focus for studies of incretin drugs. This 5-year prospective cohort study aimed to quantify possible associations between liraglutide and risk of AP and PC compared to other antidiabetic drugs (ADs).
MATERIALS AND METHODS: Patients initiating liraglutide or other ADs and enrolled in a United States health plan (2010-2014) were included. Comparisons of AP and PC incidence rates were made between matched cohorts of liraglutide initiators and initiators of other ADs. Adjudicated AP cases and algorithm-based PC cases were identified. Propensity score matched intention-to-treat (ITT) and time-on-drug (TOD) analyses were completed via Poisson regression. A latency analysis was performed for PC.
RESULTS: Median follow-up was 405 days for AP cohorts (9,995 liraglutide 1:1 matched to all comparators) and 503 days for PC cohorts (35,163 liraglutide 1:1 matched to all comparators). In the primary AP analysis, 'current' use of liraglutide was not significantly associated with elevated risk across comparators (all comparators relative risk (RR) = 1.2 (95% confidence interval (CI) 0.6-2.3)). The ITT results were similar, where in the primary analysis (ITT), no RRs were significantly associated with PC (all comparators RR = 0.7 (95% CI 0.3-1.4); latency and TOD analyses did not alter findings. There was no evidence of a dose-response effect.
CONCLUSIONS: Liraglutide was not associated with an increased risk for AP or PC although risk estimates were more variable for AP, and numbers of cases for both outcomes were limited due to the rarity of outcomes. This article is protected by copyright. All rights reserved.
MATERIALS AND METHODS: Patients initiating liraglutide or other ADs and enrolled in a United States health plan (2010-2014) were included. Comparisons of AP and PC incidence rates were made between matched cohorts of liraglutide initiators and initiators of other ADs. Adjudicated AP cases and algorithm-based PC cases were identified. Propensity score matched intention-to-treat (ITT) and time-on-drug (TOD) analyses were completed via Poisson regression. A latency analysis was performed for PC.
RESULTS: Median follow-up was 405 days for AP cohorts (9,995 liraglutide 1:1 matched to all comparators) and 503 days for PC cohorts (35,163 liraglutide 1:1 matched to all comparators). In the primary AP analysis, 'current' use of liraglutide was not significantly associated with elevated risk across comparators (all comparators relative risk (RR) = 1.2 (95% confidence interval (CI) 0.6-2.3)). The ITT results were similar, where in the primary analysis (ITT), no RRs were significantly associated with PC (all comparators RR = 0.7 (95% CI 0.3-1.4); latency and TOD analyses did not alter findings. There was no evidence of a dose-response effect.
CONCLUSIONS: Liraglutide was not associated with an increased risk for AP or PC although risk estimates were more variable for AP, and numbers of cases for both outcomes were limited due to the rarity of outcomes. This article is protected by copyright. All rights reserved.
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