Acute Pancreatitis Associated with Exenatide and Liraglutide: a Meta-Analysis

Abstract

Aims: The association between GLP-1 receptor agonists (GLP-1 RA) and acute pancreatitis (AP) has been a matter of discussion. Post-marketing cases of AP were reported to FDA, which recommended a product labelling change for exenatide in 2009. This meta-analysis was conducted in order to evaluate the risk for AP associated with both GLP-1 RA, exenatide and liraglutide, in type 2 diabetic patients. Study type: Meta-analysis of longitudinal studies. Local: Health Technology Assessment (HTA) Centre, AIBILI, Coimbra, Portugal Methods: Medline, Cochrane Library and clinicaltrials.gov were searched in order to identify RCTs or observational studies evaluating exenatide or liraglutide and reporting data on AP. Odds ratios (ORs) with 95% CIs were calculated using a random-effects model. Between-study heterogeneity was assessed using I2 statistics. Results: Of the 178 possible eligible articles, 22 studies were included. Neither exenatide (OR 0.84 [95%CI 0.58 - 1.22], I2=30%) or liraglutide (OR 0.97, [95% CI 0.21 - 4.39], I2=0%) were associated with an increased risk for AP. Conclusions: No association between GLP-1 RA and AP has been identified. However, and since AP is a rare adverse effect that can present a long-term latency, monitoring for AP in future studies evaluating GLP-1 RA remains advised.

Keywords

• GLP-1 analogues
• pancreatitis
• meta-analysis