본문 바로가기
KERD
논문KCI 등재

제2형 당뇨병 환자에서의 Liraglutide 투여와 급성 췌장염 발생의 연관성: 메타분석

The Associations Between Liraglutide and Risk of Acute Pancreatitis in Patients with Type 2 Diabetes : A Meta-analysis

박정규|최혜덕|이영훈
한국병원약사회 (The Korean Society of Health-System Pharmacists)|2020.11|병원약사회지 (Journal of Korean Society of Health-System Pharmacists)|제37권 제4호|pp. 471-484|DOI 10.32429/jkshp.2020.37.4.006

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

Meta-analysisType 2 diabetesAcute pancreatitisLiraglutide

초록

Background : Acute pancreatitis is an important and serious disease even with a relatively low incidence. Also, previous studies suggest that the coexistence of Type 2 diabetes and acute pancreatitis is closely related to an increased risk of death. However, the risk of acute pancreatitis in patients treated with liraglutide, a GLP-1 receptor agonist, has not been adequately evaluated. Objective : This meta-analysis was conducted to investigate the association between the liraglutide and acute pancreatitis in patients with Type 2 diabetes. Methods : Forty-one studies were assessed, and the results of the included studies were quantitatively integrated using the meta-analysis. The incidence of the liraglutide-related acute pancreatitis was estimated. As a sub-group analysis, four studies were assessed for comparing the liraglutide-treated groups and the control groups (placebo or other antidiabetic drugs except GLP-1 receptor agonists). Results : The incidence of acute pancreatitis was 0.4% (95% confidence interval (CI) 0.3%-0.5%). The risk of acute pancreatitis was not significantly different between the liraglutide-treated groups and the control groups (odds ratio=1.412; 95% CI 0.290-6.866). Conclusion : The incidence of liraglutide-related acute pancreatitis was relatively low and not additionally increased compared to the other antidiabetic drugs. We suggest that this meta-analysis is meaningful as evidence for the clinical use of liraglutide.

Abstract

Background : Acute pancreatitis is an important and serious disease even with a relatively low incidence. Also, previous studies suggest that the coexistence of Type 2 diabetes and acute pancreatitis is closely related to an increased risk of death. However, the risk of acute pancreatitis in patients treated with liraglutide, a GLP-1 receptor agonist, has not been adequately evaluated. Objective : This meta-analysis was conducted to investigate the association between the liraglutide and acute pancreatitis in patients with Type 2 diabetes. Methods : Forty-one studies were assessed, and the results of the included studies were quantitatively integrated using the meta-analysis. The incidence of the liraglutide-related acute pancreatitis was estimated. As a sub-group analysis, four studies were assessed for comparing the liraglutide-treated groups and the control groups (placebo or other antidiabetic drugs except GLP-1 receptor agonists). Results : The incidence of acute pancreatitis was 0.4% (95% confidence interval (CI) 0.3%-0.5%). The risk of acute pancreatitis was not significantly different between the liraglutide-treated groups and the control groups (odds ratio=1.412; 95% CI 0.290-6.866). Conclusion : The incidence of liraglutide-related acute pancreatitis was relatively low and not additionally increased compared to the other antidiabetic drugs. We suggest that this meta-analysis is meaningful as evidence for the clinical use of liraglutide.

참고문헌 (60)

  1. "The top 10 causes of death"[URL]
  2. 김보연, "Diabetes Fact Sheets in Korea, 2018: An Appraisal of Current Status", Diabetes and Metabolism Journal, 43(4), pp.487~494 (2019), 대한당뇨병학회[DOI]
  3. Nuffer WA, "Liraglutide : A new option for the treatment of obesity", Pharmacotherapy, 35(10), pp.926~934 (2015)
  4. Bode B, "An overview of the pharmacokinetics, efficacy and safety of liraglutide", Diabetes Res Clin Pract, 97(1), pp.27~42 (2012)
  5. Dungan KM, "Once-weekly dulaglutide versus oncedaily liraglutide in metformin-treated patients with type 2 diabetes(AWARD-6) : A randomised, open-label, phase 3, non-inferiority trial", Lancet, 384(9951), pp.1349~1357 (2014)
  6. Butler PC, "A critical analysis of the clinical use of incretin-based therapies : Are the GLP-1therapies safe", Diabetes Care, 36(7), pp.2118~2125 (2013)
  7. Forsmark CE, "AGA institute technical review on acute pancreatitis", Gastroenterology, 132(5), pp.2022~2044 (2007)
  8. Russo MW, "Digestive and liver diseases statistics, 2004", Gastroenterology, 126(5), pp.1448~1453 (2004)
  9. Huh JH, "Diabetes mellitus is associated with mortality in acute pancreatitis", J Clin Gastroenterol, 52(2), pp.178~183 (2018)
  10. Li L, "Incretin treatment and risk of pancreatitis in patients with type 2 diabetes mellitus : Systematic review and meta-analysis of randomised and non-randomised studies", BMJ, 348, pp.2366~ (2014)
  11. Garber A, "Liraglutide, a once-daily human glucagon-like peptide 1 analogue, provides sustained improvements in glycaemic control and weight for 2 years as monotherapy compared with glimepiride in patients with type 2 diabetes", Diabetes Obes Metab, 13(4), pp.348~356 (2011)
  12. Marso SP, "Liraglutide and cardiovascular outcomes in type 2 diabetes", N Engl J Med, 375(4), pp.311~322 (2016)
  13. Jadad AR, "Assessing the quality of reports of randomized clinical trials : is blinding necessary?", Control Clin Trials, 17(1), pp.1~12 (1996)
  14. 이준영, "메타분석", Endocrinology and Metabolism, 23(6), pp.361~378 (2008), 대한내분비학회
  15. Cochran WG, "The combination of estimates from different experiments", Biometrics, 10(1), pp.101~109 (1954)
  16. Begg CB, "Operating characteristics of a rank correlation test for publication bias", Biometrics, 50(4), pp.1088~1101 (1994)
  17. Egger M, "Bias in meta-analysis detected by a simple, graphical test", BMJ, 315(7109), pp.629~634 (1997)
  18. Vilsboll T, "Liraglutide, a long-acting human glucagon-like peptide-1 analog, given as monotherapy significantly improves glycemic control and lowers body weight without risk of hypoglycemia in patients with type 2 diabetes", Diabetes Care, 30(6), pp.1608~1610 (2007)
  19. Zinman B, "Efficacy and safety of the human glucagon-like peptide-1 analog liraglutide in combination with metformin and thiazolidinedione in patients with type 2diabetes(LEAD-4 Met+TZD)", Diabetes Care, 32(7), pp.1224~1230 (2009)
  20. Marre M, "Liraglutide, a once-daily human GLP-1analogue, added to a sulphonylurea over 26 weeks produces greater improvements in glycaemic and weight control compared with adding rosiglitazone or placebo in subjects with type 2diabetes(LEAD-1 SU)", Diabet Med, 26(3), pp.268~278 (2009)
  21. Nauck M, "Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin, in type 2diabetes : The LEAD(liraglutide effect and action in diabetes)-2 study", Diabetes Care, 32(1), pp.84~90 (2009)
  22. Russell-Jones D, "Liraglutide vs insulin glargine and placebo in combination with metformin and sulfonylurea therapy in type 2 diabetes mellitus(LEAD-5 met+SU) : A randomised controlled trial", Diabetologia, 52(10), pp.2046~2055 (2009)
  23. Buse JB, "Liraglutide once a day versus exenatide twice a day for type 2 diabetes : A 26-week randomised, parallel-group, multi-national, open-label trial(LEAD-6)", Lancet, 374(9683), pp.39~47 (2009)
  24. Kaku K, "Improved glycaemic control with minimal hypoglycaemia and no weight change with the once-daily human glucagon-like peptide-1 analogue liraglutide as add-on to sulphonylurea in japanese patients with type 2 diabetes", Diabetes Obes Metab, 12(4), pp.341~347 (2010)
  25. Pratley RE, "Liraglutide versus sitagliptin for patients with type 2 diabetes who did not have adequate glycaemic control with metformin : A 26-week, randomised, parallel-group, open-label trial", Lancet, 375(9724), pp.1447~1456 (2010)
  26. Yang W, "Liraglutide provides similar glycaemic control as glimepiride(both in combination with metformin)and reduces body weight and systolic blood pressure in asian population with type 2 diabetes from china, south korea and india : A 16-week, randomized, double-blind, active control trial", Diabetes Obes Metab, 13(1), pp.81~88 (2011)
  27. Buse JB, "Exenatide once weekly versus liraglutide once daily in patients with type 2 diabetes(DURATION-6) : A randomised, openlabel study", Lancet, 381(9861), pp.117~124 (2013)
  28. Hermansen K, "Liraglutide suppresses postprandial triglyceride and apolipoprotein B48 elevations after a fat-rich meal in patients with type 2 diabetes : A randomized, double-blind, placebo-controlled, crossover trial", Diabetes Obes Metab, 15(11), pp.1040~1048 (2013)
  29. Kapitza C, "Pharmacodynamic characteristics of lixisenatide once daily versus liraglutide once daily in patients with type 2diabetes insufficiently controlled on metformin", Diabetes Obes Metab, 15(7), pp.642~649 (2013)
  30. Charbonnel B, "Efficacy and safety over 26 weeks of an oral treatment strategy including sitagliptin compared with an injectable treatment strategy with liraglutide in patients with type 2 diabetes mellitus inadequately controlled on metformin : A randomised clinical trial", Diabetologia, 56(7), pp.1503~1511 (2013)
  31. Dungan KM, "Once-weekly dulaglutide versus once-daily liraglutide in metformin-treated patients with type 2 diabetes(AWARD-6) : A randomised, open-label, phase 3, non-inferiority trial", Lancet, 384(9951), pp.1349~1357 (2014)
  32. Pratley RE, "Once-weekly albiglutide versus once-daily liraglutide in patients with type 2 diabetes inadequately controlled on oral drugs(HARMONY 7) : A randomised, open-label, multicentre, noninferiority phase 3 study", Lancet Diabetes Endocrinol, 2(4), pp.289~297 (2014)
  33. Mathieu C, "A comparison of adding liraglutide versus a single daily dose of insulin aspart to insulin degludec in subjects with type 2 diabetes(BEGIN : VICTOZA ADDON)", Diabetes Obes Metab, 16(7), pp.636~644 (2014)
  34. Retnakaran R, "Liraglutide and the preservation of pancreatic beta-cell function in early type 2 diabetes : The LIBRA trial", Diabetes Care, 37(12), pp.3270~3278 (2014)
  35. Nandy D, "The effect of liraglutide on endothelial function in patients with type 2 diabetes", Diab Vasc Dis Res, 11(6), pp.419~430 (2014)
  36. Ahmann A, "Efficacy and safety of liraglutide versus placebo added to basal insulin analogues(with or without metformin)in patients with type 2 diabetes : A randomized, placebo-controlled trial", Diabetes Obes Metab, 17(11), pp.1056~1064 (2015)
  37. Lind M, "Liraglutide in people treated for type 2diabetes with multiple daily insulin injections:Randomised clinical trial (MDI liraglutide trial)", BMJ, 351, pp.h5364~ (2015)
  38. Odawara M, "Once-weekly glucagon-like peptide-1 receptor agonist dulaglutide significantly decreases glycated haemoglobin compared with once-daily liraglutide in japanese patients with type 2 diabetes : 52 weeks of treatment in a randomized phase III study", Diabetes Obes Metab, 18(3), pp.249~257 (2016)
  39. D’Alessio D, "Comparison of insulin glargine and liraglutide added to oral agents in patients with poorly controlled type 2diabetes", Diabetes Obes Metab, 17(2), pp.170~178 (2015)
  40. Davies MJ, "Efficacy of liraglutide for weight loss among patients with type 2 diabetes : The SCALE diabetes randomized clinical trial", JAMA, 314(7), pp.687~699 (2015)
  41. Tanaka K, "Efficacy and safety of liraglutide monotherapy compared with metformin in japanese overweight", obese patients with type 2 diabetes, 2015, pp.62(5), 399~409
  42. Kaku K, "Liraglutide is effective and well tolerated in combination with an oral antidiabetic drug in japanese patients with type 2 diabetes : A randomized, 52-week, open-label, parallel-group trial", J Diabetes Investig, 7(1), pp.76~84 (2016)
  43. Azar ST, "Efficacy and safety of liraglutide compared to sulphonylurea during ramadan in patients with type 2 diabetes(LIRA-ramadan) : A randomized trial", Diabetes Obes Metab, 18(10), pp.1025~1033 (2016)
  44. Davies MJ, "Efficacy and safety of liraglutide versus placebo as add-on to glucose-lowering therapy in patients with type 2 diabetes and moderate renal impairment(LIRA-RENAL) : A randomized clinical trial", Diabetes Care, 39(2), pp.222~230 (2016)
  45. Nauck M, "Once-daily liraglutide versus lixisenatide as add-on to metformin in type 2 diabetes : A 26-week randomized controlled clinical trial", Diabetes Care, 39(9), pp.1501~1509 (2016)
  46. Nauck MA, "A phase 2, randomized, dose-finding study of the novel once-weekly human GLP-1 analog, semaglutide, compared with placebo and open-label liraglutide in patients with type 2 diabetes", Diabetes Care, 39(2), pp.231~241 (2016)
  47. Seino Y, "Combination therapy with liraglutide and insulin in japanese patients with type 2 diabetes : A 36-week, randomized, double-blind, parallel-group trial", J Diabetes Investig, 7(4), pp.565~573 (2016)
  48. Vanderheiden A, "Effect of adding liraglutide vs placebo to a high-dose lnsulin regimen in patients with type 2 diabetes : A randomized clinical trial", JAMA Intern Med, 176(7), pp.939~947 (2016)
  49. Zang L, "Efficacy and safety of liraglutide versus sitagliptin, both in combination with metformin, in chinese patients with type 2diabetes : A 26-week, open-label, randomized, active comparator clinical trial", Diabetes Obes Metab, 18(8), pp.803~811 (2016)
  50. Bailey TS, "Efficacy and safety of switching from sitagliptin to liraglutide in subjects with type 2 diabetes(LIRASWITCH) : A randomized, double-blind, double-dummy, active-controlled 26-week trial", Diabetes Obes Metab, 18(12), pp.1191~1198 (2016)
  51. Idorn T, "Safety and efficacy of liraglutide in patients with type 2 diabetes and endstage renal disease : An investigatorinitiated, placebo-controlled, doubleblind, parallel-group, randomized trial", Diabetes Care, 39(2), pp.206~213 (2016)
  52. Kumarathurai P, "Effects of the glucagon-like peptide-1 receptor agonist liraglutide on systolic function in patients with coronary artery disease and type 2 diabetes : A randomized double-blind placebo-controlled crossover study", Cardiovasc Diabetol, 15(1), pp.105~ (2016)
  53. Smits MM, "Pancreatic effects of liraglutide or sitagliptin in overweight patients with type 2 diabetes : A 12-week randomized, placebo-controlled trial", Diabetes Care, 40(3), pp.301~308 (2017)
  54. Bouchi R, "Reduction of visceral fat by liraglutide is associated with ameliorations of hepatic steatosis, albuminuria, and micro-inflammation in type 2 diabetic patients with insulin treatment : A randomized control trial", Endocr J, 64(3), pp.269~281 (2017)
  55. Frias JP, "The sustained effects of a dual GIP", GLP-1 receptor agonist, NNC0090-2746, in patients with type 2 diabetes, 2017, pp.26(2), 343~352
  56. Lingvay I, "A 26-week randomized controlled trial of semaglutide once daily versus liraglutide and placebo in patients with type 2diabetes suboptimally controlled on diet and exercise with or without metformin", Diabetes Care, 41(9), pp.1926~1937 (2018)
  57. Pratley R, "Oral semaglutide versus subcutaneous liraglutide and placebo in type 2 diabetes(PIONEER 4) : A randomised, doubleblind, phase 3a trial", Lancet, 394(10192), pp.39~50 (2019)
  58. Alves C, "A meta-analysis of serious adverse events reported with exenatide and liraglutide : Acute pancreatitis and cancer", Diabetes Res Clin Pract, 98(2), pp.271~284 (2012)
  59. Monami M, "Safety issues with glucagon-like peptide-1 receptor agonists(pancreatitis, pancreatic cancer and cholelithiasis) : Data from randomized controlled trials", Diabetes Obes Metab, 19(9), pp.1233~1241 (2017)
  60. Lankisch PG, "Acute pancreatitis", Lancet, 386(9988), pp.85~96 (2015)

관련 논문AI추천

혈액투석 환자에서 메트포르민 복용으로 발생한 급성췌장염과 젖산산증김흥수, 박인휘, 신규태, 안영환, 이연경, 임기현, 황수현영남대학교 의과대학 · Journal of Yeungnam Medical Science2016 · 제33권 제1호Acute pancreatitis and diabetes mellitus: a reviewAllyson Richardson, Walter G. Park대한내과학회 · The Korean Journal of Internal Medicine2021 · 제36권 제1호Glucagon-like peptide-1 and glucagon-like peptide-1 receptor agonists in the treatment of type 2 diabetes이동윤, 이승아대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2017 · 제22권 제1호비만 치료에서 semaglutide의 효능 및 안전성에 대한 고찰박태은, 한승훈한국임상약학회 · 한국임상약학회지2024 · 제34권 제1호제2형 당뇨병 환자에게 인크레틴 기반 약물치료요법김헌성, 김현아한국임상약학회 · 한국임상약학회지2011 · 제21권 제2호Antihyperglycemic agent therapy for adult patients with type 2 diabetes mellitus 2017: a position statement of the Korean Diabetes Association고승현, 김난희, 김진화, 김현진, 문민경, 박석오, 이병완, 이상열, 최경묵, 허규연, the Committee of Clinical Practice Guideline of KDA대한내과학회 · The Korean Journal of Internal Medicine2017 · 제32권 제6호

이 간행물의 다른 논문 (6건)

Low Correlation Between Vancomycin Area Under the Curve Over 24 Hours to the MIC (AUC/MIC ratio) and the Trough Concentration at Steady State in Methicillin-Resistant Staphylococcus Aureus Pneumonia허경민, 박효정, 손유민, 이용석, 전경만, 민명숙, 정지은pp. 408-416다발골수종 환자의 안전한 투약을 위한 약사의 환자교육 프로세스 개선방안성유림, 오미란, 안혜림, 권은영, 김유진pp. 417-428혈액내과 임상약사의 처방중재 활동 평가유지선, 이소영, 유윤미, 김재송, 손은선pp. 429-443급성 이식편대숙주병 예방을 위한 Tacrolimus 적정 혈중농도 설정박애령, 이정연, 황보신이, 김미진pp. 444-458Vancomycin Trough 농도에 따른 효과 및 부작용 발생 평가이동건, 권은영, 윤정이, 권지은, 정지혜, 김영서, 김지원, 황보신이, 히라타수미코pp. 459-470
원문 보기