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GLP-1 agonists-induced autoimmune pancreatitis
Jasmin Mahajne1, Ernestina Angarola2, Emanuel Della Torre1,3
1Unit of Immunology, Rheumatology, Allergy and Rare Diseases, UnIRAR, IRCCS Ospedale San Raffaele, Milan, Italy.
BMJ Case Reports
|September 24, 2025
Summary
Glucagon-like peptide (GLP)-1 agonists may trigger type 1 autoimmune pancreatitis (AIP) in susceptible individuals. Researchers suggest alternative insulin therapies for type 2 diabetes patients with type 1 AIP to prevent recurrence.
Area of Science:
- Endocrinology
- Gastroenterology
- Immunology
Background:
- Autoimmune pancreatitis (AIP) presents as type 1 (IgG4-related disease) and type 2 (inflammatory bowel disease-associated).
- A third type of AIP has recently been linked to immune checkpoint inhibitors.
Purpose of the Study:
- To report three cases of type 1 AIP following glucagon-like peptide (GLP)-1 agonist treatment for type 2 diabetes mellitus (DM).
- To explore the potential role of GLP-1 agonists in the development and recurrence of type 1 AIP.
Main Methods:
- Case series reporting three patients with type 1 AIP after GLP-1 agonist therapy.
- Literature review on GLP-1 agonists' effects on pancreatic and biliary systems.
Main Results:
- Three cases of type 1 AIP were observed in patients treated with GLP-1 agonists for type 2 DM.
- GLP-1 agonists may influence pancreatic hypertrophy, cell metabolism, and antigen presentation, potentially triggering type 1 AIP in predisposed individuals.
Conclusions:
- GLP-1 agonists might be implicated in the pathogenesis of type 1 AIP.
- Recurrence of pancreatitis in type 1 AIP patients using GLP-1 agonists is hypothesized.
- Insulin-based regimens may be preferable for type 2 DM patients with co-existing type 1 AIP.
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