In the UK-based study of 71 369 people, current use of GLP-1 analogues was associated with an increased risk of bile duct and gallbladder disease compared with current use of two or more other oral antidiabetes drugs (6.1 vs 3.3 events per 1000 person-years; adjusted hazard ratio, 1.79; 95% confidence interval, 1.21–2.67). Dipeptidyl peptidase-4 (DPP-4) inhibitors, the other class of incretin-based drugs, had no such effect.
In a separate study published in the same issue of JAMA Internal Medicine, neither GLP-1 analogues nor DPP-4 inhibitors were found to increase the risk of acute pancreatitis.
From these two studies, it can be concluded that DPP-4 inhibitors are safe in terms of pancreatitis and bile duct and gall bladder disease, but that GLP-1 analogues may increase the risk of the latter. The absolute risk, however, remains low.
The two studies can be read in full at: http://dx.doi.org/10.1001/jamainternmed.2016.1531 and http://dx.doi.org/10.1001/jamainternmed.2016.1522
