Incretin-based therapies are associated with acute pancreatitis: Meta-analysis of large randomized controlled trials

•There is concern that incretin-based therapies may cause acute pancreatitis.•A prior meta-analysis of 55 small trials with just 37 events found no such effect.•Three recent large trials of DPP4 inhibitors included 80 acute pancreatitis events.•Pooling these trials showed a 82% increase in the odds of acute pancreatitis.•A significant effect remains when the prior 55 trials are added.

Previous studies have offered weak and conflicting evidence regarding the impact of incretin-based oral antihyperglycemic agents on risk of acute pancreatitis. This meta-analysis of three recent mega-trials found an 82% increase in the odds of acute pancreatitis with the use of these agents compared to usual care (95% CI, 1.17–2.82).