Although incretin-based drugs have been linked with positive outcomes including lower risk of hypoglycemia, concern has arisen that their use may increase the risk of pancreatic cancer development. In a secondary analysis where DDP-4 and glucagon-like peptide-1 receptor agonists were stratified, the study also found no independent association of increased risk of pancreatic cancer in the use of incretin-based drugs by class (DPP-4 inhibitors, 1.02, 0.84 to 1.24; glucagon-like peptide-1 receptor agonists, 1.13, 0.38 to 3.38).

In other secondary analyses’ the results remained consistent, further disassociating the likelihood of incretin-based drugs as a cause of pancreatic cancer onset. A cumulative duration of less than one year yielded an increased but non-significant pooled hazard ratio (1.53, 0.93 to 2.51), whereas longer durations of use generated pooled hazard ratios close to or below unity (1-1.9 years, 1.07, 0.82 to 1.39; ≥2 years, 0.62, 0.36 to 1.07). The analysis of time since initiation yielded pooled hazard ratios close to the null (1-1.9 years, 1.06, 0.86 to 1.31; ≥2 years, 0.93, 0.60 to 1.45). These findings were similarly observed across each class of incretin-based drug.

The patients in the study were initiated between January 2007 and June 2013, with follow-ups occurring until June 2014, meaning the longest follow-up time was 8 years. Given the latency of the cancer, the full effects of incretin-based drugs needs to be surveilled over longer durations in future studies. However the authors of the study suggest their findings do provide some reassurance to patients and clinicians with concerns of an association between incretin-based drugs and pancreatic cancer. 

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