Evidence map›Paper›PMID 26888382›Full record

ArticleBMJ (Clinical research ed.)2016

Incretin based drugs and the risk of pancreatic cancer: international multicentre cohort study.

Laurent Azoulay, Kristian B Filion, Robert W Platt, Matthew Dahl, Colin R Dormuth, Kristin K Clemens, Madeleine Durand, David N Juurlink, Laura E Targownik, Tanvir C Turin and 3 more

Registry-linked trialOpen access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT02475499. Cited by 47 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 5 pooled it
17.1field-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.

NCT02475499 completed

The Use of Incretin-based Drugs and the Risk of Pancreatic Cancer in Patients With Type 2 Diabetes

Ran2014Enrolled886,172Registered outcomes1Posted comparisons0ConditionsDiabetes Mellitus, Type 2ArmsAlpha-glucosidase inhibitors, Biguanides, DPP-4 Inhibitors, GLP-1 analogs, Meglitinides
Open the trial in the graph
3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 5 syntheses or guidelines pooled it, 114 citations in OpenAlex.

  1. Pooled it
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    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 1 country.

Laurent AzoulayCenter for Clinical Epidemiology, Lady Davis Research Institute, Jewish General Hospital, Montreal, Quebec, H3T 1E2, Canada Department of Oncology, McGill University, Montreal, Canada laurent.azoulay@mcgill.ca.
Kristian B FilionCenter for Clinical Epidemiology, Lady Davis Research Institute, Jewish General Hospital, Montreal, Quebec, H3T 1E2, Canada Department of Medicine, McGill University, Montreal, Canada.
Robert W PlattDepartments of Pediatrics and of Epidemiology, Biostatistics, and Occupational Health, McGill University, and the Research Institute of the McGill University Health Centre, Montreal, Canada.
Matthew DahlManitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada and Department of Family Medicine, McMaster University, Hamilton, Canada.
Colin R DormuthDepartment of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, Canada.
Kristin K ClemensDepartment of Medicine, Western University, London, Canada.
Madeleine DurandDepartment of Internal Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, Canada.
David N JuurlinkInstitute for Clinical Evaluative Sciences, Toronto, Canada.
Laura E TargownikManitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada and Department of Family Medicine, McMaster University, Hamilton, Canada Section of Gastroenterology, Division of Internal Medicine, University of Manitoba, Winnipeg, Canada.
Tanvir C TurinDepartment of Family Medicine, University of Calgary, Calgary, Canada.
J Michael PatersonInstitute for Clinical Evaluative Sciences, Toronto, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto.
Pierre ErnstCenter for Clinical Epidemiology, Lady Davis Research Institute, Jewish General Hospital, Montreal, Quebec, H3T 1E2, Canada Department of Medicine, McGill University, Montreal, Canada.
Canadian Network for Observational Drug Effect Studies Investigators
Jewish General Hospital · CAInstitute for Clinical Evaluative Sciences · CAUniversity of Manitoba · CACentre Hospitalier de l’Université de Montréal · CAMcGill University Health Centre · CAUniversity of British Columbia · CAUniversity of Calgary · CAWestern University · CA

Funding

Canadian Institutes of Health Research DSE-111845
6 · The paper itself

Abstract

objectiveTo determine whether the use of incretin based drugs compared with sulfonylureas is associated with an increased risk of incident pancreatic cancer in people with type 2 diabetes.

designPopulation based cohort.

settingLarge, international, multicentre study combining the health records from six participating sites in Canada, the United States, and the United Kingdom.

participantsA cohort of 972,384 patients initiating antidiabetic drugs between 1 January 2007 and 30 June 2013, with follow-up until 30 June 2014.

main outcome measuresWithin each cohort we conducted nested case-control analyses, where incident cases of pancreatic cancer were matched with up to 20 controls on sex, age, cohort entry date, duration of treated diabetes, and duration of follow-up. Hazard ratios and 95% confidence intervals for incident pancreatic cancer were estimated, comparing use of incretin based drugs with use of sulfonylureas, with drug use lagged by one year for latency purposes. Secondary analyses assessed whether the risk varied by class (dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists) or by duration of use (cumulative duration of use and time since treatment initiation). Site specific hazard ratios were pooled using random effects models.

resultsDuring 2,024,441 person years of follow-up (median follow-up ranging from 1.3 to 2.8 years; maximum 8 years), 1221 patients were newly diagnosed as having pancreatic cancer (incidence rate 0.60 per 1000 person years). Compared with sulfonylureas, incretin based drugs were not associated with an increased risk of pancreatic cancer (pooled adjusted hazard ratio 1.02, 95% confidence interval 0.84 to 1.23). Similarly, the risk did not vary by class and evidence of a duration-response relation was lacking.

conclusionsIn this large, population based study the use of incretin based drugs was not associated with an increased risk of pancreatic cancer compared with sulfonylureas. Although this potential adverse drug reaction will need to be monitored long term owing to the latency of the cancer, these findings provide some reassurance on the safety of incretin based drugs.

Indexed as

AdultAgedCanadaCase-Control StudiesDiabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsFemaleGlucagon-Like Peptide-1 Receptor AgonistsHumansHypoglycemic AgentsIncretinsMaleMiddle AgedPancreatic NeoplasmsProportional Hazards ModelsRetrospective StudiesDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsIncretinsSulfonylurea Compounds

Identifiers

PMID26888382
PMCPMC4772785
OpenAlexW2277579395

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.