Concern persists regarding the safety of GLP-1 analogue therapy in patients at risk for pancreatitis. This retrospective analysis, published in Diabetes, Obesity and Metabolism, evaluated the association between GLP-1 analogue use and recurrent pancreatitis in adults with diabetes and a history of pancreatitis or elevated lipase levels.

Data were extracted from a large health maintenance organisation comprising more than 4.5 million insured members using fully de-identified electronic health records. Adults with diabetes who had experienced pancreatitis or had lipase levels greater than 1.5 times the upper reference limit were included. Patients who used GLP-1 analogues before or within one month of the index date were excluded. GLP-1 analogue initiation during follow-up defined exposure. Survival and multivariate time-varying analyses were used to assess recurrent pancreatitis risk.

The study included 46,186 patients, including 10,933 with prior pancreatitis and 35,253 with elevated lipase. Median age was 70.9 years, and 55% were men. GLP-1 analogue use was independently associated with recurrent pancreatitis in time-varying analysis, with a hazard ratio of 1.252 (95% confidence interval 1.178 to 1.332). The association remained significant after adjustment for sex, alcohol use, and medications associated with pancreatitis.

These findings indicate an increased risk of recurrent pancreatitis among high-risk patients receiving GLP-1 analogue therapy. The results support cautious prescribing in this population, pending confirmation from prospective studies.