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Cited by 67Diabetes Treatment and ManagementPharmacology and Obesity TreatmentDiabetes Management and Research

Incretin‐Based Drugs and Risk of Intestinal Obstruction Among Patients With Type 2 Diabetes

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Faillie, Jean‐Luc, Yin, Hui, Yu, Oriana H. Y., Herrero, Astrid, Altwegg, Romain, Renoux, Christel, Azoulay, Laurent·2022·Clinical Pharmacology & Therapeutics
DOI 10.1002/cpt.2430
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Abstract

Glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) and dipeptidyl peptidase‐4 (DPP‐4) inhibitors might increase the risk of intestinal obstruction, but real‐world evidence for this severe adverse event is lacking. Thus, the objective of this study was to determine whether GLP‐1 RAs and DPP‐4 inhibitors are associated with an increased risk of intestinal obstruction compared with sodium‐glucose cotransporter‐2 (SGLT‐2) inhibitors. We used the United Kingdom Clinical Practice Research Datalink and linked databases to assemble two new‐user, active comparator cohorts (2013–2019). The first included 25,617 and 67,261 GLP‐1 RA and SGLT‐2 inhibitor users, respectively. The second included 131,927 and 40,615 DPP‐4 inhibitor and SGLT‐2 inhibitor users, respectively. Propensity score fine stratification weighted Cox proportional hazards models were fit to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of intestinal obstruction requiring hospitalization. GLP‐1 RAs were associated with an increased risk of intestinal obstruction compared with SGLT‐2 inhibitors (1.9 vs. 1.1 per 1,000 person‐years, respectively; HR: 1.69, 95% CI: 1.04–2.74). The highest HR was observed after 1.6 years of use (HR: 3.48, 95% CI: 1.79–6.79). DPP‐4 inhibitors were also associated with an increased risk (2.7 vs. 1.0 per 1,000 person‐years; HR: 2.59, 95% CI: 1.52–4.42), with the highest HR observed after 1.8 years of use (HR: 9.53, 95% CI: 4.47–20.30). The number needed to harm after 1 year of use was 1,223 and 603 for GLP‐1 RAs and DPP‐4 inhibitors, respectively. In this large real‐world study, GLP‐1 RAs and DPP‐4 inhibitors were associated with an increased risk of intestinal obstruction.

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Crossref · 10.1002/cpt.2430

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  • GLP-1 RAs are linked to an increased incidence of intestinal obstruction requiring hospitalization compared to SGLT-2 inhibitors (1.9 vs. 1.1 per 1,000 person-years; HR 1.69; 95% CI 1.04 to 2.74).

    “Similarly, an analysis utilizing the UK Clinical Practice Research Datalink (CPRD) revealed that GLP-1 RAs were linked to an increased incidence of intestinal obstruction requiring hospitalization, compared to sodium-glucose cotransporter-2 (SGLT-2) inhibitors (1.9 vs. 1.1 per 1,000 person-years; hazard ratio [HR], 1.69; 95% confidence interval [CI], 1.04 to 2.74) [11].”

    From Exploring the Side Effects of GLP-1 Receptor Agonist: To Ensure Its Optimal Positioning (2025) · cites this paper as [11]

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Authors
Faillie, J., Yin, H., Yu, O. H. Y., Herrero, A., Altwegg, R., Renoux, C., & Azoulay, L.
Affiliations
  • Inserm (FR)
  • Jewish General Hospital (CA)
  • Centre Hospitalier Universitaire de Montpellier (FR)
ORCID
Venue
Clinical Pharmacology & Therapeutics
Publisher
Wiley
Published
2021-10-16
Volume
111
Issue
1
Pages
272-282
ISSN
  • 0009-9236 (ISSN-L)
  • 1532-6535
DOI
10.1002/cpt.2430
OpenAlex
W3201928742
Cited by
67
References
8
Citations by year
2026: 15 · 2025: 25 · 2024: 22 · 2023: 5
FWCI
5.05
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Pharmacology & Therapeutics (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, other-oa)
Funders
Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
intestinal obstruction, type 2 diabetes, incretin-based therapy, GLP-1 receptor agonists, DPP-4 inhibitors, SGLT2 inhibitors, adverse drug reactions, hospitalization risk, drug safety
MeSH terms
Glucagon-Like Peptide-1 Receptor, Sodium-Glucose Transporter 2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, Aged, Diabetes Mellitus, Type 2, Female, United Kingdom, Humans, Hypoglycemic Agents, Intestinal Obstruction, Male, Middle Aged, Cohort Studies, Incidence, Proportional Hazards Models, Odds Ratio, Incretins, Dipeptidyl-Peptidase IV Inhibitors, Propensity Score

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