A meta-analysis of serious adverse events reported with exenatide and liraglutide: Acute pancreatitis and cancer

Aims: The association between GLP-1 agonists, acute pancreatitis (AP), any cancer and thyroid cancer is discussed. This meta-analysis was aimed at evaluating the risk of those serious adverse events associated with GLP-1 agonists in patients with type 2 diabetes. Methods: Medline, EMBASE, Cochrane Library and clinicaltrials.gov were searched in order to identify longitudinal studies evaluating exenatide or liraglutide use and reporting data on AP or cancer. Odds ratios (ORs) were pooled using a random-effects model. I-2 statistics assessed heterogeneity. Results: Twenty-five studies were included. Neither exenatide (OR 0.84 [95% CI 0.58-1.22], I-2 = 30%) nor liraglutide (OR 0.97 [95% CI 0.21-4.39], I-2 = 0%) were associated with an increased risk of AP, independent of baseline comparator. The pooled OR for cancer associated with exenatide was 0.86 (95% CI 0.29, 2.60, I-2 = 0%) and for liraglutide was 1.35 (95% CI 0.70, 2.59, I-2 = 0%). Liraglutide was not associated with an increased risk for thyroid cancer (OR 1.54 [95% CI 0.40-6.02], I-2 = 0%). For exenatide, no thyroid malignancies were reported. Conclusions: Current available published evidence is insufficient to support an increased risk of AP or cancer associated with GLP-1 agonists. These rare and long-term adverse events deserve properly monitoring in future studies evaluating GLP-1 agonists. (C) 2012 Elsevier Ireland Ltd. All rights reserved.