Association between Exposure to GLP-1 Treatment and Pancreatitis Risk in Obesity Patients: A Retrospective Database Study
Author(s)
Kirti Batra, MBA1, Anuj Gupta, Msc1, Abhimanyu Roy, MBA2, Abhinav Nayyar, MBBS, MBA2, Arunima Sachdev, MA2, Vikash Kumar Verma, MBA, PharmD2, Ina Kukreja, MBA, PT2, Rahul Goyal, BS Tech3, Louis Brooks Jr, MA4, Marissa Seligman, BS Pharma5, Jalyna Laney, RN6.
1Optum, Noida, India, 2Optum, Gurgaon, India, 3Optum, Phoenix, AZ, USA, 4Optum, Bloomsbury, NJ, USA, 5Optum, Boston, MA, USA, 6Optum, Atlanta, GA, USA.
1Optum, Noida, India, 2Optum, Gurgaon, India, 3Optum, Phoenix, AZ, USA, 4Optum, Bloomsbury, NJ, USA, 5Optum, Boston, MA, USA, 6Optum, Atlanta, GA, USA.
Presentation Documents
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