Association of glucagon-like peptide-1 receptor agonists with acute pancreatitis and biliary disease in individuals with diabetes and obesity: a propensity-weighted, population-based cohort study

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OBJECTIVE: To evaluate the risk of acute pancreatitis and biliary disease in patients treated with glucagon-like peptide-1 receptor agonists (GLP-1 RA). METHOD: Population-based, propensity-weighted, new user, active comparator design study including patients with diabetes and obesity initiating treatment with GLP-1 RA or the comparator group sodium-glucose cotransporter 2 inhibitors (SGLT-2i) in the region of Valencia from 2015 to 2021. RESULTS: In adjusted, per protocol main analysis, no risk differences were found for acute pancreatitis (HR: 0.56; 95%CI: 0.17-1.91) nor for biliary disease (HR: 1.12; IC95%: 0.79, 1.58). Secondary analyses yielded similar results. CONCLUSIONS: Despite we did not observe increased risk of gastrointestinal events in GLP-1 RA vs SGLT-2i patients, adherence to approved indications and close monitoring of potential adverse events are warranted to ensure patient safety.

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