Dipeptidyl peptidase-4 inhibitors and pancreatitis risk: a meta-analysis of randomized clinical trials
Article first published online: 28 JUL 2013
© 2013 John Wiley & Sons Ltd
Diabetes, Obesity and Metabolism
Volume 16, Issue 1, pages 48–56, January 2014
How to Cite
Monami, M., Dicembrini, I. and Mannucci, E. (2014), Dipeptidyl peptidase-4 inhibitors and pancreatitis risk: a meta-analysis of randomized clinical trials. Diabetes, Obesity and Metabolism, 16: 48–56. doi: 10.1111/dom.12176
- Issue published online: 17 DEC 2013
- Article first published online: 28 JUL 2013
- Accepted manuscript online: 9 JUL 2013 12:20PM EST
- Manuscript Accepted: 2 JUL 2013
- Manuscript Revised: 11 JUN 2013
- Manuscript Received: 17 APR 2013
- antidiabetic drug;
- type 2 diabetes
Some observational studies reporting an increased risk of pancreatitis in association with Dipeptidyl Peptidase-4 inhibitors (DPP4i) have raised concerns on the overall safety of this class. Aim of the present meta-analysis is the systematic collection of information on pancreatitis in randomized clinical trials with DPP4i.
Data Sources: an extensive Medline, Embase and Cochrane Database search for ‘vildagliptin’, ‘sitagliptin’, ‘saxagliptin’, ‘alogliptin’, ‘linagliptin’ and ‘dutogliptin’ was performed up to 1 March 2013. Study Selection: studies were included if they satisfied the following criteria: (i) randomized trials, (ii) duration ≥12 weeks, (iii) on type 2 diabetes and (iv) comparison of DPP4i with placebo or active drugs. The identification and the selection of studies, and the subsequent data extraction were performed independently by two authors. Mantel-Haenszel odds ratio with 95% Confidence Interval (MH-OR) was calculated for all the adverse events defined below. The principal outcome was the effect of DPP4i on the incidence of pancreatitis.
A total of 134 eligible trials were identified. The overall risk of pancreatitis and pancreatic cancer was not different between DPP4i and comparators (MH-OR: 0.93[0.51–1.69]; p = 0.82).
It should be recognized that the number of observed cases of incident pancreatitis is small and the confidence intervals of risk estimates are wide. However, the present meta-analysis do not suggest any increase in the risk of pancreatitis with DPP4i.