Risk of recurrent acute pancreatitis with GLP-1 receptor agonists after prior pancreatitis: a systematic review
- Design
- Systematic review · 10624 participants · Hard outcome
- Match to healthy normal-weight adults aged 55–75
- Different populationINDIRECT: all participants had type 2 diabetes or obesity and a history of acute pancreatitis.
- Could weight loss explain it?
- UnlikelyA safety question with no raised risk found; the abstract reports no weight or glycaemic analysis.
- Study tier
- Study tier 3LOW: a small systematic review in which only two studies gave comparative data and the included study designs are not stated.
- Assessment
- Version 4 · Two reviewers differed; settled by a recorded ruling · Oct 19, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
This systematic review gathered four studies of 10,624 adults with type 2 diabetes or obesity who had previously had acute pancreatitis; 5,427 (51.0%) used GLP-1 receptor agonists. GLP-1 drug use was not linked to more repeat pancreatitis: odds were lower than with SGLT2 inhibitors (OR 0.57), the comparison with placebo (OR 0.26, 95% CI 0.05-1.32) was too imprecise to be conclusive, and two other studies reported recurrence in 9.9% and 11.9% of users. Only two studies compared groups and their designs are not given in the abstract, so the authors urge caution.
01Findings
What the study reported
- Drugs
- Glp-1 receptor agonists
- Comparator
- placebo and SGLT2 inhibitors (two comparative studies)
- Dose
- various
- Primary outcome
- recurrent acute pancreatitis
- Effect
- Versus placebo OR 0.26 (CI includes no effect); versus SGLT2 inhibitors OR 0.57; recurrence rates among GLP-1 RA users 9.9% and 11.9% in two non-comparative studies; no increase in recurrent pancreatitis
- 95% confidence interval
- 95% CI 0.05-1.32 (vs placebo); 95% CI 0.52-0.64 (vs SGLT2 inhibitors)
- Follow-up
- Not stated
- Adverse events
- GLP-1 RA use was not associated with an increase in recurrent acute pancreatitis after prior pancreatitis; recurrence rates 9.9% and 11.9% among users in two studies
- Limitations
- Only four studies, with comparative evidence from two, and the included study designs are not stated in the abstract; the authors urge cautious interpretation.
Who was studied
- Obesity status
- mixed (type 2 diabetes or obesity)
- Diabetes status
- mixed (type 2 diabetes or obesity)
- Cvd status
- not reported in abstract
- Ckd status
- not reported in abstract
- Baseline condition
- prior acute pancreatitis
- Sample size
- 10624
- Inclusion exclusion
- adults with prior acute pancreatitis treated with GLP-1 RAs for type 2 diabetes, obesity or related conditions; studies without recurrent pancreatitis outcomes, pediatric populations, overlapping cohorts, insufficient data or non-original publications excluded
Study quality details
- Study design
- Systematic review
- Sample size
- 10624
- Randomization
- n/a
- Blinding
- n/a
- Comparator
- placebo and SGLT2 inhibitors (two comparative studies)
- Follow up duration
- not stated
- Outcome type
- hard
- Replication
- not assessed
- Consistency with other evidence
- not assessed
- Population applicability
- INDIRECT
- Statistical precision
- CIs reported; comparative evidence from two studies (5,224 GLP-1 RA users; 5,197 controls); wide CI versus placebo
- Risk of bias
- not assessed
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- not stated in source
- Sponsor role
- not reported in abstract
- Author conflicts
- The authors declare no competing interests and report no relationships that could be construed as a conflict of interest.
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
[INTRODUCTION] Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for patients with type 2 diabetes (T2D) and obesity. However, their safety in patients with prior pancreatitis remains uncertain. This systematic review aims to evaluate the risk of recurrent acute pancreatitis (RAP) associated with GLP-1 RA therapy. [METHODS] We systematically searched for studies evaluating the safety of GLP-1 receptor agonists in adults with type 2 diabetes mellitus (T2DM) or obesity and a history of acute pancreatitis. The primary outcome was recurrent acute pancreatitis. We included studies of adults with prior acute pancreatitis treated with GLP-1 receptor agonists for type 2 diabetes, obesity, or related metabolic conditions. Studies without recurrent acute pancreatitis outcomes, pediatric populations, overlapping cohorts, insufficient data, or non-original publications were excluded. [RESULTS] We included four studies comprising 10,624 patients, of whom 5,427 (51.0%) received GLP-1 receptor agonists. Two studies provided comparative data (5,224 GLP-1 RA users; 5,197 controls). GLP-1 receptor agonist use was associated with lower odds of recurrent acute pancreatitis than placebo (OR 0.26, 95% CI 0.05-1.32) and lower risk than SGLT2 inhibitor use (OR 0.57, 95% CI 0.52-0.64). Two additional studies provided recurrence rates among GLP-1 RA users with prior pancreatitis, reporting rates of 9.9% (95% CI 5.8%-16.3%) and 11.9% (95% CI 5.1%-25.8%). [CONCLUSION] Across the four included studies, GLP-1 receptor agonist use was not associated with an increase in RAP among patients with a prior history of acute pancreatitis. However, comparative evidence was limited to two studies, warranting cautious interpretation of these findings.
Where this record came from
| Source | Retrieved | Identifier |
|---|---|---|
| pubmed | Oct 18, 2026 | 42873314 first ingestion |