Section of Geriatric Cardiology and Medicine, Careggi Teaching Hospital, Via delle Oblate 4, 50141 Florence, Italy.
Obesity Agency, Careggi Teaching Hospital, Via delle Oblate 4, 50141 Florence, Italy; Diabetes Agency, Careggi Teaching Hospital, Via delle Oblate 4, 50141 Florence, Italy.
Diabetes Res Clin Pract. 2014 Feb;103(2):269-75. doi: 10.1016/j.diabres.2014.01.010. Epub 2014 Jan 14.
Several randomized trials with metabolic outcomes have reported that glucagon like peptide-1 receptor agonists (GLP-1 RA) could be associated with an increased risk of pancreatitis. The present meta-analysis aimed to examine this hypothesis.
An extensive Medline, Embase, and Cochrane Database search for "exenatide", "liraglutide", "albiglutide", "taspoglutide", "dulaglutide", "lixisenatide", and "semaglutide" was performed up to March 31st, 2013.
(i) randomized trials, (ii) duration ≥12 weeks; (iii) on type 2 diabetes; and (iv) comparison of GLP-1RA with placebo or active drugs. Mantel-Haenszel odds ratio with 95% confidence interval (MH-OR) was calculated for pancreatitis.
80 eligible trials were identified. Of these, 39 had not disclosed their findings or did not report any information on pancreatitis. The remaining 41 trials enrolled 14,972 patients, with a total exposure of 14,333 patient × years (8353 and 5980 patient × years for GLP-1 receptor agonists and comparators, respectively). The overall risk of pancreatitis was not different between GLP-1RA and comparators (MH-OR: 1.01[0.37; 2.76]; p = 0.99).
The present meta-analysis does not suggest any increase in the risk of pancreatitis with the use of GLP-1RA. However, it should be recognized that the number of observed cases of incident pancreatitis is very small and the confidence intervals of risk estimates are wide.
几项代谢结局的随机试验报告称，胰高血糖素样肽-1 受体激动剂（GLP-1RA）可能与胰腺炎风险增加相关。本荟萃分析旨在检验这一假说。
对 Medline、Embase 和 Cochrane 数据库进行了广泛的检索，检索词为“exenatide”、“liraglutide”、“albiglutide”、“taspoglutide”、“dulaglutide”、“lixisenatide”和“semaglutide”，检索时间截至 2013 年 3 月 31 日。
（i）随机试验，（ii）持续时间≥12 周；（iii）治疗 2 型糖尿病；（iv）GLP-1RA 与安慰剂或活性药物比较。采用 Mantel-Haenszel 比值比（MH-OR）和 95%置信区间（MH-OR）计算胰腺炎的比值比。
共纳入 80 项符合条件的试验。其中，39 项试验未报告或未报告胰腺炎的结果。其余 41 项试验纳入了 14972 名患者，总暴露时间为 14333 患者×年（GLP-1 受体激动剂和对照组分别为 8353 和 5980 患者×年）。GLP-1RA 与对照组的胰腺炎总体风险无差异（MH-OR：1.01[0.37; 2.76]；p = 0.99）。
本荟萃分析结果提示 GLP-1RA 不会增加胰腺炎的风险。然而，应该认识到观察到的胰腺炎病例数非常少，风险估计的置信区间较宽。
