Division of Endocrinology, Hospital de Clínicas de Porto Alegre/Universidade Federal do Rio Grande do Sul, Ramiro Barcelos St, 2350, Prédio 12, 4th floor, ZIP 90035-903, Porto Alegre, Brazil.
Sci Rep. 2018 Jan 15;8(1):782. doi: 10.1038/s41598-017-19055-6.
The use of dipeptidyl peptidase-4 (DPP-4) inhibitors may be associated with pancreatic cancer and acute pancreatitis. Recent meta-analyses have reported conflicting findings. Therefore, we performed a meta-analysis to assess the risk of both pancreatic cancer and acute pancreatitis associated with the use of DPP-4 inhibitors. We also used trial sequential analysis to evaluate whether the number of patients included was enough to reach conclusions. We included randomised controlled trials lasting 24 weeks or more that compared DPP-4 inhibitors with placebo or other antihyperglycaemic agents. A total of 59,404 patients were included. There was no relationship between the use of DPP-4 inhibitors and pancreatic cancer (Peto odds ratio 0.65; 95% CI 0.35-1.21), and the optimal sample size was reached to determine a number needed to harm (NNH) of 1000 patients. DPP-4 inhibitors were associated with increased risk for acute pancreatitis (Peto odds ratio 1.72; 95% CI 1.18-2.53), with an NNH of 1066 patients, but the optimal sample size for this outcome was not reached. In conclusion, there is no association between DPP-4 inhibitors and pancreatic cancer, and a small risk for acute pancreatitis was observed with DPP-4 inhibitor use, although the latter finding is not definitive.
二肽基肽酶-4（DPP-4）抑制剂的使用可能与胰腺癌和急性胰腺炎有关。最近的荟萃分析报告了相互矛盾的结果。因此，我们进行了一项荟萃分析，以评估 DPP-4 抑制剂的使用与胰腺癌和急性胰腺炎的风险。我们还使用试验序贯分析来评估纳入的患者数量是否足以得出结论。我们纳入了持续 24 周或更长时间的随机对照试验，比较了 DPP-4 抑制剂与安慰剂或其他降血糖药物。共有 59404 名患者纳入研究。DPP-4 抑制剂的使用与胰腺癌之间没有关系（Peto 比值比 0.65；95%置信区间 0.35-1.21），并且达到了最佳样本量，可以确定需要治疗的患者数（NNH）为 1000 例。DPP-4 抑制剂与急性胰腺炎风险增加相关（Peto 比值比 1.72；95%置信区间 1.18-2.53），NNH 为 1066 例，但该结局的最佳样本量尚未达到。总之，DPP-4 抑制剂与胰腺癌之间没有关联，并且观察到 DPP-4 抑制剂使用与急性胰腺炎的风险增加，但后者的发现并不明确。
