The Effect of Glucagon-Like Peptide-1 Receptor Agonists on Pain Management in Chronic Pancreatitis: A Real-World...

Chronic pancreatitis (CP) is a debilitating inflammatory condition characterized by irreversible glandular destruction and intractable pain. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated anti-inflammatory properties in preclinical models, yet their impact on clinical outcomes in CP remains unexplored.

In this retrospective cohort study, adult patients (≥18 years) with CP were identified from the TriNetX US Collaborative Network. Patients were stratified into the following two cohorts: those prescribed GLP-1 RAs and a control group without such prescriptions. 1:1 propensity score matching was performed to balance cohorts for age, sex, race, and key comorbidities. Primary outcomes were assessed over a 3-year observation period. Hazard ratios (HRs) were estimated using Kaplan-Meier survival analysis.

After matching, 10,625 patients were included in each cohort (mean age 59.6 ± 13.1 years; 53.7% female). GLP-1 RA users had a 41% lower hazard of initiating chronic opioids (HR 0.59, 95% confidence interval [CI] 0.52-0.67; P < .001) and a 42% lower hazard of developing opioid use disorder (HR 0.58, 95% CI 0.48-0.69; P < .001). GLP-1 RA therapy was also associated with a marked reduction in the risk of requiring celiac plexus block (HR 0.51, 95% CI 0.34-0.78; P = .001) and endoscopic pancreatic interventions (HR 0.48, 95% CI 0.41-0.56; P < .001). Furthermore, the risk of undergoing major pancreatic surgery was significantly lower in the GLP-1 RA group (HR 0.44, 95% CI 0.33-0.59; P < .001).

GLP-1 RA use was associated with a substantial reduction in new opioid prescriptions and invasive pancreatic interventions in CP. These findings suggest that GLP-1 RAs may be helpful in symptom control and multidisciplinary management of selected cases.