Use of the Japanese health insurance claims database to assess the risk of acute pancreatitis in patients with diabetes: comparison of DPP-4 inhibitors with other oral antidiabetic drugs

Diabetes Obes Metab. 2015 Apr;17(4):430-4. doi: 10.1111/dom.12381. Epub 2014 Sep 17.

Abstract

This study was initiated to evaluate the association of acute pancreatitis (AP) with the use of dipeptidyl peptidase-4 (DPP-4) inhibitors among patients with diabetes in Japan. A retrospective cohort study of a large medical and pharmacy claims database was performed to compare the incidence of AP among those receiving DPP-4 inhibitors and those receiving other oral antidiabetic drugs. The incidence of all AP and hospitalizations for AP was similar between the two groups. Previous exposure to DPP-4 inhibitors did not affect occurrence of AP in patients on other oral antidiabetic drugs. The Kaplan-Meier curve for time to AP was similar between the two groups, and was not affected by previous exposure to DPP-4 inhibitors. The Cox proportional hazard models showed the incidence of AP was not significantly higher in those receiving DPP-4 inhibitors. Despite numerous, important limitations related to claims database-based analyses, our results indicate that there is no increased risk of AP with use of DPP-4 inhibitors among patients with diabetes in Japan.

Keywords: acute pancreatitis; claims database; dipeptidyl peptidase-4 inhibitor.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Cohort Studies
  • Databases, Factual
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / immunology
  • Dipeptidyl-Peptidase IV Inhibitors / administration & dosage
  • Dipeptidyl-Peptidase IV Inhibitors / adverse effects*
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use
  • Female
  • Health Benefit Plans, Employee
  • Hospitalization
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects*
  • Hypoglycemic Agents / therapeutic use
  • Incidence
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Pancreas / drug effects*
  • Pancreas / immunology
  • Pancreatitis / chemically induced*
  • Pancreatitis / epidemiology
  • Pancreatitis / immunology
  • Pancreatitis / therapy
  • Retrospective Studies
  • Risk
  • Survival Analysis

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Hypoglycemic Agents