Dipeptidyl peptidase-4 inhibitors, pancreatic cancer and acute pancreatitis: A meta-analysis with trial sequential analysis.
Dipeptidyl peptidase-4 inhibitors, pancreatic cancer and acute pancreatitis: A meta-analysis with trial sequential analysis.
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DOI：
10.1038/s41598-017-19055-6
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发表时间：
2018-01-15
影响因子：
4.6
通讯作者：
Gross JL
中科院分区：
文献类型：
--
作者：
Pinto LC;Rados DV;Barkan SS;Leitão CB;Gross JL
二肽基肽酶-4（DPP-4）抑制剂的使用可能与胰腺癌和急性胰腺炎相关。最近的荟萃分析报告了相互矛盾的结果。因此，我们进行了一项荟萃分析，以评估与使用DPP-4抑制剂相关的胰腺癌和急性胰腺炎风险。我们还使用试验序贯分析来评估纳入的患者数量是否足以得出结论。我们纳入了持续24周或更长时间的比较DPP-4抑制剂与安慰剂或其他抗高血压药物的随机对照试验。共纳入59，404例患者。DPP-4抑制剂的使用与胰腺癌之间无相关性（Peto比值比0.65; 95% CI 0.35-1.21），达到最佳样本量以确定1000例患者所需的伤害数量（NNH）。DPP-4抑制剂与急性胰腺炎风险增加相关（Peto比值比1.72; 95% CI 1.18-2.53），NNH为1066例患者，但未达到该结局的最佳样本量。总之，DPP-4抑制剂与胰腺癌之间无相关性，使用DPP-4抑制剂时观察到急性胰腺炎的风险较小，尽管后一结果并不确定。
The use of dipeptidyl peptidase-4 (DPP-4) inhibitors may be associated with pancreatic cancer and acute pancreatitis. Recent meta-analyses have reported conflicting findings. Therefore, we performed a meta-analysis to assess the risk of both pancreatic cancer and acute pancreatitis associated with the use of DPP-4 inhibitors. We also used trial sequential analysis to evaluate whether the number of patients included was enough to reach conclusions. We included randomised controlled trials lasting 24 weeks or more that compared DPP-4 inhibitors with placebo or other antihyperglycaemic agents. A total of 59,404 patients were included. There was no relationship between the use of DPP-4 inhibitors and pancreatic cancer (Peto odds ratio 0.65; 95% CI 0.35–1.21), and the optimal sample size was reached to determine a number needed to harm (NNH) of 1000 patients. DPP-4 inhibitors were associated with increased risk for acute pancreatitis (Peto odds ratio 1.72; 95% CI 1.18–2.53), with an NNH of 1066 patients, but the optimal sample size for this outcome was not reached. In conclusion, there is no association between DPP-4 inhibitors and pancreatic cancer, and a small risk for acute pancreatitis was observed with DPP-4 inhibitor use, although the latter finding is not definitive.
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DOI：
10.1136/bmj.g2366
发表时间：
2014-04-15
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Li L;Shen J;Bala MM;Busse JW;Ebrahim S;Vandvik PO;Rios LP;Malaga G;Wong E;Sohani Z;Guyatt GH;Sun X
通讯作者：
Sun X
影响因子：
7.7
作者：
Matveyenko AV;Dry S;Cox HI;Moshtaghian A;Gurlo T;Galasso R;Butler AE;Butler PC
通讯作者：
Butler PC
影响因子：
158.5
作者：
Scirica, Benjamin M.;Bhatt, Deepak L.;Simmons, D.
通讯作者：
Simmons, D.
影响因子：
5.1
作者：
Roshanov, Pavel S.;Dennis, Brittany B.
通讯作者：
Dennis, Brittany B.
DOI：
10.1056/nejmoa1305889
发表时间：
2013-10-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
White, William B;Cannon, Christopher P;Zannad, Faiez
通讯作者：
Zannad, Faiez