Evidence mapPaperPMID 41555834Full record

ArticleDiabetes, obesity & metabolism2026

Risk of acute pancreatitis with DPP-4 inhibitors versus SGLT2 inhibitors in medication-naïve individuals with diabetes: A target trial emulation.

Takashi Tatewaki, Akira Okada, Yuya Kimura, Hideo Yasunaga

Abstract readComparative Study
In one paragraph

Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Takashi TatewakiDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.ORCID https://orcid.org/0009-0008-5515-6930
Akira OkadaDepartment of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.ORCID https://orcid.org/0000-0001-6480-3388
Yuya KimuraDepartment of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Hideo YasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.

Funding

Japan Association for Diabetes Education and Care 2024-YNG-031Ministry of Health, Labour and Welfare 23AA2003
6 · The paper itself

Abstract

aimsWe investigated whether dipeptidyl peptidase-4 inhibitor (DPP-4i) use was associated with a higher risk of acute pancreatitis compared with sodium-glucose cotransporter 2 inhibitor (SGLT2i) use in antidiabetic medication-naïve individuals. MATERIALS AND

methodsIn this target trial emulation study of medication-naïve individuals with diabetes from a Japanese claims database from April 2014 to August 2023, the risk of acute pancreatitis was compared between new users of DPP-4is and new users of SGLT2is. After adjusting for confounders using propensity score-based overlap weighting, we used Cox proportional hazards models for hospitalization due to acute pancreatitis to estimate the hazard ratio (HR) and 95% confidence interval (CI) within the groups in both the intention-to-treat and per-protocol analyses. We also calculated incidence rate differences (IRDs) per 1000 person-years.

resultsThis study included 26 133 DPP4-i and 6497 SGLT2i users. DPP-4i use was not significantly associated with a higher risk of acute pancreatitis compared with SGLT2i use; the adjusted HRs were 0.97 (95% CI, 0.51-1.83) and 1.11 (95% CI, 0.54-2.27), with IRDs of -0.05 (95% CI, -0.97 to 0.87) and 0.15 (95% CI, -0.86 to 1.15) per 1000 person-years in the intention-to-treat and per-protocol analyses, respectively.

conclusionsAlthough small differences cannot be excluded given the width of the CIs for the estimated HRs, the small IRDs observed suggest that any potential difference, if present, is likely to be clinically modest. Therefore, acute pancreatitis risk may not be a major determinant when selecting initial therapy.

Indexed as

Diabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsHypoglycemic AgentsPancreatitisSodium-Glucose Transporter 2 InhibitorsAcute DiseaseAdultAgedFemaleHumansIncidenceJapanMaleMiddle AgedRisk FactorsDipeptidyl-Peptidase IV InhibitorsHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsDPP‐IV inhibitorobservational studypharmaco‐epidemiologySGLT2 inhibitor

Identifiers

PMID41555834
PMCPMC12992197

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