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Dipeptidyl-peptidase-4 inhibitors and pancreatic cancer: a cohort study.

Publication ,  Journal Article
Gokhale, M; Buse, JB; Gray, CL; Pate, V; Marquis, MA; Stürmer, T
Published in: Diabetes, obesity & metabolism
December 2014

To compare pancreatic cancer incidence and diagnostic evaluation among patients initiating dipeptidyl-peptidase-4 (DPP-4) inhibitor treatment with those initiating sulfonylureas (SU) and thiazolidinediones (TZD).Medicare claims data were examined in a new-user active-comparator cohort study. Patients >65 years with no prescriptions for DPP-4 inhibitors, SU or TZD at baseline were included if they had at least two claims for the same drug within 180 days. Using an as-treated approach and propensity score-adjusted Cox models, we estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) for pancreatic cancer. Diagnostic evaluations were compared using risk ratios.In the DPP-4 inhibitor versus SU comparison, there were 18 179 patients who initiated treatment with DPP-4 inhibitors, of whom 26 developed pancreatic cancer (interquartile range follow-up 5-18 months). In the DPP-4 inhibitor versus TZD comparison there were 29 366 people initiating DPP-4 inhibitor treatment and 52 of these developed pancreatic cancer. The risk of pancreatic cancer with DPP-4 inhibitor treatment was lower relative to SU treatment (HR: 0.6, CI: 0.4-0.9) and similar to TZD treatment (HR: 1.0, 95% CI: 0.7-1.4). After the first 6 months of follow-up were excluded to reduce the potential for reverse causality, the results were not altered. The probability of diagnostic evaluation after commencing DPP-4 inhibitor treatment (79.3%) was similar to that for TZD (74.1%, risk ratio 1.06, 95% CI: 1.05-1.07) and SU (74.6%) (risk ratio 1.06, 95% CI: 1.05-1.07). The probability of diagnostic evaluation before the index date (date of initiating treatment) was ∼80% for all cohorts.Although the present study was limited by sample size and the observed duration of treatment in the USA, our well-controlled population-based study suggests there is no higher short-term pancreatic cancer risk with DPP-4 inhibitor treatment relative to SU or TZD treatment.

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Published In

Diabetes, obesity & metabolism

DOI

EISSN

1463-1326

ISSN

1462-8902

Publication Date

December 2014

Volume

16

Issue

12

Start / End Page

1247 / 1256

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Thiazolidinediones
  • Sulfonylurea Compounds
  • Proportional Hazards Models
  • Propensity Score
  • Pancreatic Neoplasms
  • Odds Ratio
  • Middle Aged
 

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Gokhale, M., Buse, J. B., Gray, C. L., Pate, V., Marquis, M. A., & Stürmer, T. (2014). Dipeptidyl-peptidase-4 inhibitors and pancreatic cancer: a cohort study. Diabetes, Obesity & Metabolism, 16(12), 1247–1256. https://doi.org/10.1111/dom.12379
Gokhale, M., J. B. Buse, C. L. Gray, V. Pate, M. A. Marquis, and T. Stürmer. “Dipeptidyl-peptidase-4 inhibitors and pancreatic cancer: a cohort study.Diabetes, Obesity & Metabolism 16, no. 12 (December 2014): 1247–56. https://doi.org/10.1111/dom.12379.
Gokhale M, Buse JB, Gray CL, Pate V, Marquis MA, Stürmer T. Dipeptidyl-peptidase-4 inhibitors and pancreatic cancer: a cohort study. Diabetes, obesity & metabolism. 2014 Dec;16(12):1247–56.
Gokhale, M., et al. “Dipeptidyl-peptidase-4 inhibitors and pancreatic cancer: a cohort study.Diabetes, Obesity & Metabolism, vol. 16, no. 12, Dec. 2014, pp. 1247–56. Epmc, doi:10.1111/dom.12379.
Gokhale M, Buse JB, Gray CL, Pate V, Marquis MA, Stürmer T. Dipeptidyl-peptidase-4 inhibitors and pancreatic cancer: a cohort study. Diabetes, obesity & metabolism. 2014 Dec;16(12):1247–1256.
Journal cover image

Published In

Diabetes, obesity & metabolism

DOI

EISSN

1463-1326

ISSN

1462-8902

Publication Date

December 2014

Volume

16

Issue

12

Start / End Page

1247 / 1256

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Thiazolidinediones
  • Sulfonylurea Compounds
  • Proportional Hazards Models
  • Propensity Score
  • Pancreatic Neoplasms
  • Odds Ratio
  • Middle Aged