Pancreatitis and pancreatic cancer in patients with type 2 diabetes treated with glucagon-like peptide-1 receptor agonists: an updated meta-analysis of randomized controlled trials
Abstract
INTRODUCTION: An association between glucagon-like peptide-1 receptor agonists (GLP1-RA) and risk of pancreatitis and pancreatic cancer has been suggested. Since its first description, several new trials (including three cardiovascular outcome trials) have been published, substantially increasing the available data set. This suggests the need for an update of the previous meta-analysis. EVIDENCE ACQUISITION: A Medline search for GLP-1 receptor agonists (exenatide, liraglutide, lixisenatide, albiglutide, dulaglutide, or semaglutide) was performed, collecting all randomized clinical trials, with duration ≥52 weeks, enrolling patients with type 2 diabetes, and comparing a GLP-1 receptor agonist with placebo or any other non-GLP-1 receptor agonist drug. The endpoints were pancreatitis, pancreatic cancer reported as serious adverse events. Mantel-Haenszel Odds Ratio (MH-OR) with 95% confidence interval (95% CI) was calculated for all outcomes defined above, on an intention-to-treat basis. EVIDENCE SYNTHESIS: A total of 43 trials fulfilling inclusion criteria (all reporting data on pancreatitis and pancreatic cancer) was identified. GLP-1 RA showed no association with pancreatitis (MH-OR 1.24 [0.94, 1.64]; P=0.13) and pancreatic cancer (MH-OR 1.28 [0.87, 1.89]; P=0.20). CONCLUSIONS: No clear evidence of risk for pancreatitis was observed, whereas data on pancreatic cancer are too scarce to draw any conclusion.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Nreu et al. and Monami et al. found that the incidence of pancreatitis and pancreatic cancer with GLP-1 receptor agonists including semaglutide was not significantly different from that observed in comparator arms.
“Both Nreu et al. (39), Monami et al. (40) found that the incidence of pancreatitis and pancreatic cancer with GLP-1 RAs including semaglutide was not significant from that observed in comparator arms.”
From Gastrointestinal adverse events associated with semaglutide: A pharmacovigilance study based on FDA adverse event reporting system (2022) · cites this paper as [39]
Cites
The publisher hasn’t deposited this paper’s reference list.
Cited by
Sorted by citations
Thomsen, R. W., Mailhac, A., Løhde, J. B., & Pottegård, A. (2025) · Diabetes Obesity and Metabolism · doi:10.1111/dom.16364 · Cited by 207 · see citing works
Adverse drug reactions of GLP-1 agonists: A systematic review of case reports
Shetty, R., Basheer, F. T., Poojari, P. G., Thunga, G., Chandran, V. P., & Acharya, L. D. (2022) · Diabetes & Metabolic Syndrome: Clinical Research & Reviews · doi:10.1016/j.dsx.2022.102427 · Cited by 145 · see citing works
Shu, Y., He, X., Wu, P., Liu, Y., Ding, Y., & Zhang, Q. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.996179 · Cited by 145 · see citing works
Mahapatra, M. K., Karuppasamy, M., & Sahoo, B. M. (2022) · Pharmaceutical Research · doi:10.1007/s11095-022-03302-1 · Cited by 110 · see citing works
Efficacy and safety of semaglutide for weight management: evidence from the STEP program
Amaro, A., Sugimoto, D. H., & Wharton, S. (2022) · Postgraduate Medicine · doi:10.1080/00325481.2022.2147326 · Cited by 65 · see citing works
Type 2 Diabetes Mellitus Intersects With Pancreatic Cancer Diagnosis and Development
Duan, X., Wang, W., Pan, Q., & Guo, L. (2021) · Frontiers in Oncology · doi:10.3389/fonc.2021.730038 · Cited by 41 · see citing works
Repurposing metabolic regulators: antidiabetic drugs as anticancer agents
Dhas, Y., Biswas, N., Divyalakshmi, M. R., Jones, L., & Ashili, S. (2024) · Molecular Biomedicine · doi:10.1186/s43556-024-00204-z · Cited by 38 · see citing works
Ayoub, M., Faris, C., Juranovic, T., Chela, H. K., & Daglilar, E. S. (2024) · Cancers · doi:10.3390/cancers16091625 · Cited by 37 · see citing works
Glucagon-Like Peptide-1 Based Therapies: A New Horizon in Obesity Management
Son, J. W., & Lim, S. (2024) · Endocrinology and Metabolism · doi:10.3803/enm.2024.1940 · Cited by 33 · see citing works
Dotan, I., Rudman, Y., Turjeman, ., Akirov, A., Steinmetz, T., Calvarysky, B., & Diker‐Cohen, T. (2024) · Transplantation · doi:10.1097/tp.0000000000004945 · Cited by 34 · see citing works
Sharma, N., Khatib, M. N., Balaraman, A. K., Roopashree, R., Kaur, M., Srivastava, M., Barwal, A., Prasad, G. V. S., Rajput, P., Syed, R., et al. (2024) · International Urology and Nephrology · doi:10.1007/s11255-024-04266-4 · Cited by 21 · see citing works
Chou, O. H. I., Zhou, J., Mui, J. V., Satti, D. I., Chung, C. T., Lee, T. T. L., Lee, S., Dee, E. C., Ng, K., Cheung, B. M. Y., et al. (2022) · Diabetes Epidemiology and Management · doi:10.1016/j.deman.2022.100115 · Cited by 18 · see citing works
Kupnicka, P., Król, M., Żychowska, J., Łagowski, R., Prajwos, E., Surówka, A., & Chlubek, D. (2024) · Pharmaceuticals · doi:10.3390/ph17111470 · Cited by 22 · see citing works
What is the evidence regarding the safety of new obesity pharmacotherapies
Vidal, J., Flores, L., Jiménez, A., Pané, A., & de Hollanda, A. (2025) · International Journal of Obesity · doi:10.1038/s41366-024-01488-5 · Cited by 15 · see citing works
Fernando, K., Bain, S. C., Holmes, P., Jones, P. N., & Patel, D. (2021) · Diabetes Therapy · doi:10.1007/s13300-021-01116-9 · Cited by 16 · see citing works
GLP-1 Receptor Agonists and Cardiovascular Disease: What Do Clinicians Need to Know?
Hayat, J., Shah, N. P., Agarwala, A., Khan, M. S., & Butler, J. (2024) · Current Atherosclerosis Reports · doi:10.1007/s11883-024-01214-6 · Cited by 9 · see citing works
Grancini, V., Cogliati, I., Alicandro, G., Oliverio, A., Benedetto, C. D., Gaglio, A., Lampertico, P., Resi, V., & Orsi, E. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1586941 · Cited by 6 · see citing works
Severe, Complicated Pancreatitis With an Unclear Etiology
Nohomovich, B., Shah, A. A., & Hughes, N. (2023) · Cureus · doi:10.7759/cureus.39011 · Cited by 3 · see citing works
Timmermans, M., Topal, B., Sanches, E. E., de Jongh, F. W., Çağıltay, E., Çelik, A., Ribeiro, R. J. D. S., Parmar, C. D., Ugale, S. M., Proczko, M., et al. (2021) · Minerva Endocrinology · doi:10.23736/s2724-6507.21.03296-x · Cited by 3 · see citing works
Molecular Mechanisms Against Successful Weight Loss and Promising Treatment Options in Obesity
Szekeres, Z., Szabados, E., & Pálfi, A. (2025) · Biomedicines · doi:10.3390/biomedicines13081989 · Cited by 3 · see citing works
Exocrine Pancreatic Insufficiency During the Use of Semaglutide: A Case Report
de Melo, C. A., Júnior, N. E. G., Ribeiro-Sousa, M. A. D. S., & da Cunha, S. F. D. C. (2024) · Cureus · doi:10.7759/cureus.55549 · Cited by 2 · see citing works
Grancini, V., Cogliati, I., Gaglio, A., Resi, V., & Orsi, E. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1392371 · Cited by 1 · see citing works
Antidiabetic drugs and neuroendocrine neoplasms: a double-edged sword?
DICITORE, A. (2022) · Minerva Medica · doi:10.23736/s0026-4806.21.07846-0
Bánhegyi, R. J., Gazdag, A., Rácz, B., Szalai, L., Wagner, R. J., & Fülöp, N. (2022) · Orvosi Hetilap · doi:10.1556/650.2022.32041
Secondary diabetes mellitus: focusing on type 3c diabetes and post-immunotherapy new onset diabetes
Ragni, A. (2023) · The Journal of AMD · doi:10.36171/jamd23.26.2.8
The effect of semaglutide on body weight in patients with type 2 diabetes mellitus
Demidova, T. Y., & Titova, V. V. (2024) · FOCUS Endocrinology · doi:10.15829/2713-0177-2024-5-1-04
- Authors
- Nreu, B., Dicembrini, I., Tinti, F., Mannucci, E., & Monami, M.
- Affiliations
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Corresponding author
- Monami, Matteo
- Venue
- Minerva Endocrinology
- Publisher
- Edizioni Minerva Medica
- Published
- 2020-07
- Volume
- 48
- Issue
- 2
- Pages
- 206-213
- ISSN
- 0391-1977 (ISSN-L)
- 2724-6116
- OpenAlex
- W3046710325
- Cited by
- 27
- References
- 0
- Citations by year
- 2025: 3 · 2024: 11 · 2023: 3 · 2022: 7 · 2021: 3
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Minerva Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- GLP-1 receptor agonists, pancreatitis, pancreatic cancer, type 2 diabetes, exenatide, liraglutide, lixisenatide, albiglutide, dulaglutide, semaglutide, serious adverse events, drug safety
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Pancreatic Neoplasms, Pancreatitis, Randomized Controlled Trials as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
