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Dipeptidyl-peptidase-4 inhibitors and pancreatic cancer: a cohort study

Gokhale, M. ; Buse, J. B. ; Gray, C. L. ; Pate, V. ; Marquis, M. A. ; Stürmer, T.

Diabetes, obesity & metabolism, 2014-12, Vol.16 (12), p.1247-1256

Oxford, UK: Blackwell Publishing Ltd

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Título:
Dipeptidyl-peptidase-4 inhibitors and pancreatic cancer: a cohort study
Autor: Gokhale, M. ; Buse, J. B. ; Gray, C. L. ; Pate, V. ; Marquis, M. A. ; Stürmer, T.
Assuntos: Aged ; Aged, 80 and over ; antidiabetic drug ; Cohort Studies ; Confidence intervals ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - mortality ; Dipeptidyl-Peptidase IV Inhibitors - administration & dosage ; Dipeptidyl-Peptidase IV Inhibitors - adverse effects ; DPP-IV inhibitor ; Drug Therapy, Combination ; Female ; Humans ; Hypoglycemic Agents - administration & dosage ; Hypoglycemic Agents - adverse effects ; Incidence ; incretin therapy ; Male ; Medical research ; Medicare ; Middle Aged ; Odds Ratio ; Pancreatic cancer ; Pancreatic Neoplasms - chemically induced ; Pancreatic Neoplasms - diagnosis ; Pancreatic Neoplasms - epidemiology ; Propensity Score ; Proportional Hazards Models ; Sulfonylurea Compounds - administration & dosage ; Sulfonylurea Compounds - adverse effects ; Thiazolidinediones - administration & dosage ; Thiazolidinediones - adverse effects ; Time Factors ; Treatment Outcome ; United States - epidemiology
É parte de: Diabetes, obesity & metabolism, 2014-12, Vol.16 (12), p.1247-1256
Notas: National Center for Advancing Translational Sciences
National Center for Research Resources
National Institutes of Health (NIH) - No. UL1TR000083
ark:/67375/WNG-MXW5R3X5-H
ArticleID:DOM12379
Table S1. Codes used to exclude prevalent cancer at baseline (Page 2).Table S2. List of codes for diagnostic evaluation (Page 27).Table S3. Diagnostic evaluation in the initiators of dipeptidyl-peptidase-IV inhibitors (DPP-4i), sulfonylureas (SU) and thiazolidinediones (TZD) in the 6 months before and after the index date (Page 30).Table S4. Time between two prescriptions of each drug (Page 33).Table S5. Distribution of person time for initiators of each drug (Page 34).Figure S1. Eligibility diagram for dipeptidyl-peptidase-IV inhibitors (DPP-4i) and sulfonylureas (SU) new user cohort (Page 35).Figure S2. Eligibility Diagram for dipeptidyl-peptidase-IV inhibitors (DPP-4i) and thiazolidinediones (TZD) new user cohort (Page 36).
istex:5657292457133A83E48DC3CFD1DFAC514C28DDDC
Descrição: Aim To compare pancreatic cancer incidence and diagnostic evaluation among patients initiating dipeptidyl‐peptidase‐4 (DPP‐4) inhibitor treatment with those initiating sulfonylureas (SU) and thiazolidinediones (TZD). Methods Medicare claims data were examined in a new‐user active‐comparator cohort study. Patients >65 years with no prescriptions for DPP‐4 inhibitors, SU or TZD at baseline were included if they had at least two claims for the same drug within 180 days. Using an as‐treated approach and propensity score‐adjusted Cox models, we estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) for pancreatic cancer. Diagnostic evaluations were compared using risk ratios. Results In the DPP‐4 inhibitor versus SU comparison, there were 18 179 patients who initiated treatment with DPP‐4 inhibitors, of whom 26 developed pancreatic cancer (interquartile range follow‐up 5–18 months). In the DPP‐4 inhibitor versus TZD comparison there were 29 366 people initiating DPP‐4 inhibitor treatment and 52 of these developed pancreatic cancer. The risk of pancreatic cancer with DPP‐4 inhibitor treatment was lower relative to SU treatment (HR: 0.6, CI: 0.4–0.9) and similar to TZD treatment (HR: 1.0, 95% CI: 0.7–1.4). After the first 6 months of follow‐up were excluded to reduce the potential for reverse causality, the results were not altered. The probability of diagnostic evaluation after commencing DPP‐4 inhibitor treatment (79.3%) was similar to that for TZD (74.1%, risk ratio 1.06, 95% CI: 1.05–1.07) and SU (74.6%) (risk ratio 1.06, 95% CI: 1.05–1.07). The probability of diagnostic evaluation before the index date (date of initiating treatment) was ∼80% for all cohorts. Conclusion Although the present study was limited by sample size and the observed duration of treatment in the USA, our well‐controlled population‐based study suggests there is no higher short‐term pancreatic cancer risk with DPP‐4 inhibitor treatment relative to SU or TZD treatment.
Editor: Oxford, UK: Blackwell Publishing Ltd
Idioma: Inglês

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Dipeptidyl-peptidase-4 inhibitors and pancreatic cancer: a cohort study

Gokhale, M. ; Buse, J. B. ; Gray, C. L. ; Pate, V. ; Marquis, M. A. ; Stürmer, T.

Oxford, UK: Blackwell Publishing Ltd

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