Using RCT Data to Evaluate the Association of DPP-4 Inhibitors on Pancreatitis and/or Pancreatic Cancer Risk in T2DM: A Systematic Review and Meta-analysis / 中国药学杂志

ABSTRACT

OBJECTIVE: To review systematically the association of dipeptidyl peptidase-4 inhibitors on pancreatitis and/or pancreatic cancer risk in type-2 diabetes mellitus. METHODS: Databases including The Cochrane Library, PubMed, Embase, Clinical Trials. gov, CNKI, WanFang Data and CBM, were searched electronically for randomized controlled trials (RCTs) of DPP-4 inhibitors in pancreatitis and pancreatic cancer risk in T2DM patients up to June 2017. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then Metaanalysis was performed using Rev Man 5.3 software. RESULTS: A total of 39 RCTs involving 65 189 patients were included. The results of Meta-analysis showed that there were no significant differences between the DPP-4 inhibitors group and the control group in the pancreatitis and/or pancreatic cancer adverse events (RR = 0.92, 95%CI 0.69 to 1.23, P = 0.59), pancreatitis (RR = 1.05, 95% CI 0.76 to 1.4, P = 0.79) and pancreatic cancer (RR = 0.62, 95%CI (0.35, 1.08), P = 0.09). Subgroup analyses showed there were no significant differences of acute pancreatitis events between DPP-4 inhibitors group and the control group (RR = 1.42, 95%CI 0.82 to 2.47, P = 0.21). CONCLUSION: The present Meta-analysis of RCTs data does not suggest that DPP-4 inhibitors are associated with pancreatitis and/or pancreatic cancer. Long-term clinical studies are required to further prove this conclusion.