1635-P: Risk of Pancreatitis among Patients with Type 2 Diabetes Receiving DPP-4 Inhibitors: Nationwide Case-Control Study

Dipeptidyl peptidase-4 inhibitors (DPP-4i) are widely used antidiabetic incretin-based drugs. There remain concerns about the pancreatic safety of DPP-4i due to its pleiotropic effects on the exocrine pancreas. We studied whether DPP-4i are associated with acute and chronic pancreatitis using nationwide population-based cohort study. This study included patients with newly diagnosed type 2 diabetes being treated with antidiabetic drugs (n = 33,208) from 2007 to 2013, from the sample cohort (n = 514,866) of the ***** National Health Insurance Service-Health Screening Cohort database. A Cox proportional hazards model with time-dependent covariates was used to calculate the risk. Lag time of 6 months was applied to reflect a cumulative effect of DPP-4i. Subgroup analyses were also performed according to various confounding factors. Of the 33,208 subjects, 10,210 new DPP-4i users and 22,998 new users of antidiabetic drugs other than DPP-4i were included. DPP-4i significantly increased the risk for pancreatitis (adjusted hazard ratio (aHR) 1.26, 95% CI 1.06-1.50) even after adjusting for age, sex, BMI, smoking and alcohol status, Charlson comorbidity index, and residential region. With a drug-use lag exposure of 6 months, aHR for pancreatitis was still statistically significant as similar (aHR 1.23, 95% CI 1.01-1.51) In subgroup analyses, the risk of pancreatitis was apparent only in subjects with a higher comorbidity score, suggesting a clinical factor which increases the risk of pancreatitis by DPP-4i use. In an analysis of data from a large nation-wide cohort database, we found that DPP-4i are associated with the increased risk of pancreatitis in patients with newly diagnosed type 2 diabetes.