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Predictors of acute pancreatitis in patients treated with GLP-1 receptor agonists for weight management
Robert Postlethwaite1, Amin M Amin2, Rand Alsawas2
1Division of Gastroenterology and Hepatology, University of Texas Medical Branch, Galveston, TX, USA.
Introduction:
Glucagon-like peptide-1 receptor agonists (GLP-1RA) are widely prescribed for treating obesity and Type 2 Diabetes (T2D). There have been concerns that GLP-1RA is associated with acute pancreatitis (AP), although the data are controversial. We aimed to identify factors that impact the risk of AP after initiation of GLP-1RA treatment for obesity.
Methods:
We performed a retrospective case-control study including adults patients initiated on a GLP-1RA for obesity management to determine risk factors associated with AP in obese patients taking GLP-1RA. We identified patients initiated on GLP-1RA. A multivariable logistic regression model was used to identify predictors of AP with GLP-1RA use.
Results:
There were 2245 patients, of which 49 (2.2 %) developed AP after starting a GLP-1RA. A history of gallstone disease (adjusted odds ratio (aOR), 2.9 [95 % CI, 1.6 to 5.3]), history of AP (aOR 4.8 [CI, 1.8 to 13.2]), CAD/PVD (aOR 2 [CI, 1.01 to 3.9]) and tobacco use (aOR 2.4 [CI, 1.2 to 4.7]) were associated with a higher risk of AP with GLP-1RA use. Compared to a BMI ≤30 kg/m2, BMI categories 36-40 and > 40 were associated with a lower risk of AP with GLP-1RA therapy, (aOR 0.2 [CI, 0.06 to 0.6]) and (aOR 0.25 [CI, 0.09 to 0.68]), respectively.
Conclusion:
A history of gallstone disease, history of AP, CAD/PVD, and tobacco use were associated with AP after initiation of GLP-1RA for obesity treatment. A higher BMI appears to be protective against AP. Recognizing factors associated AP after GLP-1RA initiation can inform clinicians on risk stratification.
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