Adverse drug reactions associated with the use of liraglutide in patients with type 2 diabetes – focus on pancreatitis and pancreas cancer

Abstract

Introduction: The glucagon-like peptide-1 (GLP-1) receptor agonist, liraglutide, is a widely used drug for the treatment of type 2 diabetes. Liraglutide is one of several incretin-based agents that have been suggested to be associated with pancreatitis and pancreas cancer. The suspicion accelerated after publication of an autopsy study claiming increased incidences of several pathological changes in pancreata from patients with diabetes treated with incretin-based drugs.

Areas covered: The aim of the present review is to give an overview of the pharmacology of liraglutide and provide a review of adverse reactions associated with liraglutide with a focus on the risk of pancreatitis and pancreas cancer.

Expert opinion: When comprehensively reviewing the available literature, no clear and significant associations between liraglutide and pancreatitis and/or pancreas cancer seem evident. However, a recently published analysis suggests a trend toward a slightly elevated risk of pancreatitis with GLP-1 receptor agonists (including liraglutide), which may become statistical significant as more data become available. Well-established side effects are of gastrointestinal origin, typical mild-to-moderate and of transient character. The risk of hypoglycemia associated with liraglutide treatment is low.

Keywords:

• adverse reactions
• cancer
• glucagon-like peptide-1
• liraglutide
• pancreas
• pancreatitis
• type 2 diabetes

Declaration of interest

T Vilsbøll has received research support and/or fees for being part of an advisory board, lecturing and/or consulting from AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb, Eli Lilly, GI Dynamics, Merck Sharp & Dohme, Novo Nordisk, Novartis, Sanofi-Aventis, Takeda, and Zealand Pharma. FK Knop has received research support and/or fees for being part of an advisory board, lecturing, and/or consulting from AstraZeneca, Boehringer Ingelheim Pharmaceuticals Bristol-Myers Squibb, Eli Lilly, GI Dynamics, Gilead Sciences, Merck Sharp & Dohme, Novartis, Novo Nordisk, Ono Pharmaceuticals, Sanofi-Aventis, and Zealand Pharma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.