Evidence map›Paper›PMID 23645885›Full record

ArticleDiabetes care2013

A critical analysis of the clinical use of incretin-based therapies: Are the GLP-1 therapies safe?

Peter C Butler, Michael Elashoff, Robert Elashoff, Edwin A M Gale

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02244164 (Pathophysiological Study of the Increase in Pancreatic Volume in Type 2 Diabetes Treatments.), which is not on this map. Cited by 128 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
128citing papers in PubMed, 9 pooled it
35.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02244164 naterminatednot on this mapstarted 2014, after this paper: background citation

Pathophysiological Study of the Increase in Pancreatic Volume in Type 2 Diabetes Treatments.

TypeinterventionalSponsorErasme University HospitalRan2014 to 2023Enrolled5ConditionsType 2 Diabetes, Incretinomimetics, PancreasArmsIncretinomimetics, DPP-4 inhibitors
3 · Its place in the literature

Who cites it

128 citing papers in PubMed, 9 syntheses or guidelines pooled it, 292 citations in OpenAlex.

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  12. GLP-1 receptor agonists-a potential therapy for chronic kidney disease?Clinical science (London, England : 1979) · 2026
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68 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

Peter C ButlerLarry L. Hillblom Islet Research Center, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA.
Michael Elashoff
Robert Elashoff
Edwin A M Gale
University of California, Los Angeles · USUniversity of Bristol · GB

Funding

UCLA Clinical and Translational Science InstituteUL1TR000124 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DUBINETT, STEVEN M. · 2012 to 2015
$57.0M
Role of IAPP in Islet Dysfunction in DiabetesR01DK059579 · NIDDK · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BUTLER, PETER CAWOOD · 2001 to 2019
$7.5M
Role of Pulsatile Insulin Secretion.R01DK061539 · NIDDK · UNIVERSITY OF SOUTHERN CALIFORNIA · PI BUTLER, PETER CAWOOD · 2002 to 2012
$4.1M
Capacity and Mechanisms of Beta Cell Regeneration in HumansR01DK077967 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI BUTLER, PETER CAWOOD · 2008 to 2016
$2.5M
NCATS NIH HHS UL1 TR000124NCATS NIH HHS UL1TR000124NIDDK NIH HHS DK059579NIDDK NIH HHS DK061539NIDDK NIH HHS DK077967NIDDK NIH HHS R01 DK059579NIDDK NIH HHS R01 DK061539NIDDK NIH HHS R01 DK077967
6 · The paper itself

Abstract

There is no question that incretin-based glucose-lowering medications have proven to be effective glucose-lowering agents. Glucagon-like peptide 1 (GLP-1) receptor agonists demonstrate an efficacy comparable to insulin treatment and appear to do so with significant effects to promote weight loss with minimal hypoglycemia. In addition, there are significant data with dipeptidyl peptidase 4 (DPP-4) inhibitors showing efficacy comparable to sulfonylureas but with weight neutral effects and reduced risk for hypoglycemia. However, over the recent past there have been concerns reported regarding the long-term consequences of using such therapies, and the issues raised are in regard to the potential of both classes to promote acute pancreatitis, to initiate histological changes suggesting chronic pancreatitis including associated preneoplastic lesions, and potentially, in the long run, pancreatic cancer. Other issues relate to a potential risk for the increase in thyroid cancer. There are clearly conflicting data that have been presented in preclinical studies and in epidemiologic studies. To provide an understanding of both sides of the argument, we provide a discussion of this topic as part of this two-part point-counterpoint narrative. In the point narrative below, Dr. Butler and colleagues provide their opinion and review of the data to date and that we need to reconsider the use of incretin-based therapies because of the growing concern of potential risk and based on a clearer understanding of the mechanism of action. In the counterpoint narrative following the contribution by Dr. Butler and colleagues, Dr. Nauck provides a defense of incretin-based therapies and that the benefits clearly outweigh any concern of risk.

Indexed as

AnimalsDiabetes MellitusDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 ReceptorHumansHypoglycemic AgentsIncretinsReceptors, GlucagonDipeptidyl-Peptidase IV InhibitorsGLP1R protein, humanGlucagon-Like Peptide-1 ReceptorHypoglycemic AgentsIncretinsReceptors, Glucagon

Identifiers

PMID23645885
PMCPMC3687282
OpenAlexW2054925541

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.