School of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, Liaoning, China.
Department of Pharmacy, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
Clin Ther. 2024 Aug;46(8):650-656. doi: 10.1016/j.clinthera.2024.06.015. Epub 2024 Jul 31.
This meta-analysis sought to assess the relationship between dipeptidyl peptidase-4 inhibitors (DPP-4) and the risk of pancreatitis and pancreatic cancer by synthesizing data from randomized, controlled trials, in light of the conflicting findings from observational studies and previous meta-analyses.
Cochrane, Embase, ClinicalTrials.gov, and PubMed databases that compared the use of DPP-4 inhibitors and that reported pancreatitis and pancreatic cancer events in patients with diabetes mellitus Type 2 (T2DM) were searched using specific terms. Studies were included if they satisfied the following inclusion criteria: They were randomized trials comparing DPP-4 inhibitors use in patients with T2DM; The study's duration was longer than 24 weeks; And they reported pancreatitis and pancreatic cancer events. Stata 15 MP was used to analyze the data, and odds ratios (OR) with 95% confidence intervals (CI) were used to represent the results.
A total of 81,737 participants with T2DM were included in the analysis. The results showed that during a mean follow-up period of 24 to 520 weeks, The use of DPP-4 inhibitors was not associated with an increased risk of pancreatitis (Peto-OR 0.97; 95% CI: 0.74, 1.27) or pancreatic cancer (Peto-OR = 0.88; 95% CI: 0.59, 1.30).
Current evidence fails to validate a significant correlation between DPP-4 therapy and pancreatitis or pancreatic cancer. However, subgroup analyses showed that sitagliptin was associated with a significant reduction in pancreatitis risk compared to the control group; furthermore, when comparing different types of control medications, a significant decrease in pancreatic cancer risk was observed among DPP-4 users compared to GLP-1 users.
本荟萃分析旨在综合随机对照试验的数据，评估二肽基肽酶-4 抑制剂（DPP-4）与胰腺炎和胰腺癌风险之间的关系，鉴于观察性研究和先前荟萃分析得出的相互矛盾的结果。
使用特定术语搜索 Cochrane、Embase、ClinicalTrials.gov 和 PubMed 数据库，以比较 DPP-4 抑制剂的使用情况，并报告 2 型糖尿病（T2DM）患者的胰腺炎和胰腺癌事件。符合以下纳入标准的研究被纳入：它们是比较 DPP-4 抑制剂在 T2DM 患者中的使用的随机试验；研究持续时间超过 24 周；并报告了胰腺炎和胰腺癌事件。使用 Stata 15 MP 分析数据，并用比值比（OR）和 95%置信区间（CI）表示结果。
共有 81737 名 T2DM 患者纳入分析。结果显示，在平均 24 至 520 周的随访期间，DPP-4 抑制剂的使用与胰腺炎（Peto-OR 0.97；95%CI：0.74，1.27）或胰腺癌（Peto-OR = 0.88；95%CI：0.59，1.30）风险增加无关。
目前的证据无法验证 DPP-4 治疗与胰腺炎或胰腺癌之间存在显著相关性。然而，亚组分析显示，与对照组相比，西格列汀与胰腺炎风险显著降低相关；此外，在比较不同类型的对照药物时，与 GLP-1 使用者相比，DPP-4 使用者的胰腺癌风险显著降低。
