Czaplicka Agata, Kaleta Beata
Department of Internal Medicine and Gastroenterology, Brodnowski Hospital of the Mazovian, Kondratowicza 8, 03-242 Warsaw, Poland.
Department of Clinical Immunology, Medical University of Warsaw, 02-006 Warsaw, Poland.
J Diabetes Metab Disord. 2024 May 5;23(1):487-495. doi: 10.1007/s40200-024-01430-6. eCollection 2024 Jun.
In recent years, new hypoglycaemic drugs that affect the incretin system have become increasingly popular in the treatment of type 2 diabetes mellitus (T2DM): glucagon-like receptor 1 agonists (GLP1RAs), dipeptidyl peptidase 4 inhibitors (DPP4is) and the recently developed dual glucagon-like receptor 1 agonist and glucose-dependent insulinotropic polypeptide (tirzepatide). Their main role of these drugs is to normalise blood glucose levels. In addition, GLP1RAs are approved for the treatment of excessive body weight. The efficacy of drugs affecting the incretin system is well described in the literature, however, there are still only few reports about their safety. This review aims to summarize the results of current research and meta-analyses on risk of acute pancreatitis (AP) during incretin-affecting drugs treatment.
A narrative review was performed using present literature in an attempt to identify the relationship between AP and incretin-affecting drugs. The following keywords were used: acute pancreatitis, glucagon-like receptor 1 agonists, dipeptidyl peptidase 4 inhibitors and tirzepatide.
It was demonstrated that the use of DPP4is is safe for the majority of patients with T2DM, whereas a risk of AP should be noted in case of GLP1RAs therapy. To date, most studies found no significant association between tirzepatide therapy and the increased risk of AP.
The majority of studies have shown that DPP4is, GLP1RAs and tirzepatide are effective and safe in most T2DM patients. However, the follow-up time for patients treated with tirzepatide is short, therefore more studies are required to confirm the safety of this drug.
近年来，影响肠促胰岛素系统的新型降糖药物在2型糖尿病（T2DM）治疗中越来越受欢迎：胰高血糖素样肽-1受体激动剂（GLP1RAs）、二肽基肽酶4抑制剂（DPP4is）以及最近研发的双重胰高血糖素样肽-1受体激动剂和葡萄糖依赖性促胰岛素多肽（替尔泊肽）。这些药物的主要作用是使血糖水平正常化。此外，GLP1RAs被批准用于治疗超重。影响肠促胰岛素系统药物的疗效在文献中有充分描述，然而，关于其安全性的报道仍然很少。本综述旨在总结当前关于肠促胰岛素影响药物治疗期间急性胰腺炎（AP）风险的研究和荟萃分析结果。
采用现有文献进行叙述性综述，试图确定AP与肠促胰岛素影响药物之间的关系。使用了以下关键词：急性胰腺炎、胰高血糖素样肽-1受体激动剂、二肽基肽酶4抑制剂和替尔泊肽。
已证明，对于大多数T2DM患者而言，使用DPP4is是安全的，而在GLP1RAs治疗时应注意AP风险。迄今为止，大多数研究未发现替尔泊肽治疗与AP风险增加之间存在显著关联。
大多数研究表明，DPP4is、GLP1RAs和替尔泊肽对大多数T2DM患者有效且安全。然而，接受替尔泊肽治疗患者的随访时间较短，因此需要更多研究来证实该药物的安全性。
