Association between Exposure to GLP-1 Treatment and Pancreatitis Risk in Obesity Patients: A Retrospective Database Study
Moderator
Jalyna Laney, RN
Speakers
Kirti Batra, MBA, Optum Global Solutions, Ghaziabad, India; Anuj Gupta; Abhimanyu Roy, MBA; Abhinav Nayyar, Optum Life Sciences, Gurugram, India; Arunima Sachdev, MA, Optum, Gurgaon, India; Vikash K Verma, MBA, PharmD, Optum Lifesciences, Boston, MA, United States; Ina Kukreja, Optum, New Delhi, India; Rahul Goyal; Louis Brooks Jr; Marissa Seligman
OBJECTIVES: Prior studies highlight increased gastrointestinal risks with GLP-1 receptor agonists in Type 2 diabetes patients. However, real-world evidence on GLP-1 and pancreatitis risk in obese patients is scarce. This study investigates association between GLP-1 use and pancreatitis risk in obesity.
METHODS: This retrospective database study utilized administrative claims and electronic health records (EHR) from 01/01/2015 to 06/30/2024. Adults with GLP-1 treatment from 07/01/2015 to 12/31/2023 (index date = earliest claim or EHR for GLP-1), and evidence of obesity (≥1 obesity diagnosis claim or body mass index [BMI] ≥ 30) during 6-month pre-index period were categorized by BMI class: class 3 obesity (BMI ≥40 kg/m²), class 2 obesity (35-40 kg/m²), and class 1 obesity (30-35 kg/m²). Patients with GLP-1s and pancreatitis during pre-index period were excluded. Pancreatitis incidence rates were calculated per 100,000 person-years at risk, and Kaplan-Meier analysis was performed.
RESULTS: Overall, 510,183 GLP-1 users with obesity (37.4% class 1, 27.6% class 2, 35.0% class 3) were identified, with mean ± SD age as 52.3 ± 12.9 years, 65.3% female, 55.3% Non-Hispanic White, 21% Medicare enrollees, and mean ± SD Charlson comorbidity index as 1.0 ± 1.5. The 3-year cumulative incidence rate in Class 1, Class 2, and Class 3 obesity cohorts was 1.8%, 1.7%, and 1.6%, respectively (p<0.001). In patients with diabetes, Class 1 obesity had 17.7% higher and Class 2 obesity had 7.5% higher incidence of pancreatitis, compared to Class 3 obesity patients (both p<0.05). However, Class 3 obesity patients without diabetes had 14.0% and 15.0% higher pancreatitis incidence than those with Class 1 and Class 2 obesity, respectively (both p<0.05).
CONCLUSIONS: GLP-1 users faced increased pancreatitis risk as obesity levels decreased, particularly with concurrent diabetes. This necessitates caution in prescribing GLP-1 for obesity patients. Further research is needed to identify patient characteristics influencing this risk.
METHODS: This retrospective database study utilized administrative claims and electronic health records (EHR) from 01/01/2015 to 06/30/2024. Adults with GLP-1 treatment from 07/01/2015 to 12/31/2023 (index date = earliest claim or EHR for GLP-1), and evidence of obesity (≥1 obesity diagnosis claim or body mass index [BMI] ≥ 30) during 6-month pre-index period were categorized by BMI class: class 3 obesity (BMI ≥40 kg/m²), class 2 obesity (35-40 kg/m²), and class 1 obesity (30-35 kg/m²). Patients with GLP-1s and pancreatitis during pre-index period were excluded. Pancreatitis incidence rates were calculated per 100,000 person-years at risk, and Kaplan-Meier analysis was performed.
RESULTS: Overall, 510,183 GLP-1 users with obesity (37.4% class 1, 27.6% class 2, 35.0% class 3) were identified, with mean ± SD age as 52.3 ± 12.9 years, 65.3% female, 55.3% Non-Hispanic White, 21% Medicare enrollees, and mean ± SD Charlson comorbidity index as 1.0 ± 1.5. The 3-year cumulative incidence rate in Class 1, Class 2, and Class 3 obesity cohorts was 1.8%, 1.7%, and 1.6%, respectively (p<0.001). In patients with diabetes, Class 1 obesity had 17.7% higher and Class 2 obesity had 7.5% higher incidence of pancreatitis, compared to Class 3 obesity patients (both p<0.05). However, Class 3 obesity patients without diabetes had 14.0% and 15.0% higher pancreatitis incidence than those with Class 1 and Class 2 obesity, respectively (both p<0.05).
CONCLUSIONS: GLP-1 users faced increased pancreatitis risk as obesity levels decreased, particularly with concurrent diabetes. This necessitates caution in prescribing GLP-1 for obesity patients. Further research is needed to identify patient characteristics influencing this risk.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH40
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
SDC: Gastrointestinal Disorders