Abstract
Objectives
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for glycaemic control in type 2 diabetes (T2DM) and weight loss in obese patients. However, the effect of GLP-1 RAs on the risk of developing hepato-pancreato-biliary diseases remains unclear. Therefore, we aim to compare the effects of two antidiabetic drugs, GLP-1 RAs and Dipeptidyl peptidase-4 inhibitors (DPP-4i), on conditions affecting the liver, pancreas and biliary system using a target trial emulation design.
Methods
Using data from the electronic health records in IQVIA Medical Research Data (IMRD), we performed a large-scale, population-based cohort study to compare the risks of developing hepato-pancreato-biliary diseases between GLP-1 RAs and DPP-4i among people with T2DM using a ‘per-protocol’ approach. The propensity score fine stratification weighting method was applied along with competing risk Cox proportional hazard regression models to obtain crude and adjusted hazard ratios (aHRs) and their corresponding 95% confidence intervals. Benjamini-Yekutieli correction method for multiple testing was applied to reduce the risk of type 1 error. Study design and data extraction were facilitated via Dexter, a platform for automated epidemiological research.
Results
The study included 7,842 GLP-1 RA new users and 34,698 DPP-4i new users (2007-2023). GLP-1 RA was associated with reduced risks of alcohol misuse (aHR 0.57, 95% CI 0.44 to 0.74, corrected p-value <0.001) and MASLD (0.69, 0.55 to 0.86, 0.006), but did not have a significant association with other chronic liver disease (1.12, 0.95 to 1.31, 0.50), gallstone (1.22, 1.01 to 1.48, 0.14), and chronic pancreatitis (1.27, 0.87 to 1.88, 0.50).
Conclusions
We found that the use of GLP-1 RAs, compared to DPP-4i, were associated with a decreased risk of alcohol misuse and MASLD but not with other chronic liver disease, gallstone, and chronic pancreatitis.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for glycaemic control in type 2 diabetes (T2DM) and weight loss in obese patients. However, the effect of GLP-1 RAs on the risk of developing hepato-pancreato-biliary diseases remains unclear. Therefore, we aim to compare the effects of two antidiabetic drugs, GLP-1 RAs and Dipeptidyl peptidase-4 inhibitors (DPP-4i), on conditions affecting the liver, pancreas and biliary system using a target trial emulation design.
Methods
Using data from the electronic health records in IQVIA Medical Research Data (IMRD), we performed a large-scale, population-based cohort study to compare the risks of developing hepato-pancreato-biliary diseases between GLP-1 RAs and DPP-4i among people with T2DM using a ‘per-protocol’ approach. The propensity score fine stratification weighting method was applied along with competing risk Cox proportional hazard regression models to obtain crude and adjusted hazard ratios (aHRs) and their corresponding 95% confidence intervals. Benjamini-Yekutieli correction method for multiple testing was applied to reduce the risk of type 1 error. Study design and data extraction were facilitated via Dexter, a platform for automated epidemiological research.
Results
The study included 7,842 GLP-1 RA new users and 34,698 DPP-4i new users (2007-2023). GLP-1 RA was associated with reduced risks of alcohol misuse (aHR 0.57, 95% CI 0.44 to 0.74, corrected p-value <0.001) and MASLD (0.69, 0.55 to 0.86, 0.006), but did not have a significant association with other chronic liver disease (1.12, 0.95 to 1.31, 0.50), gallstone (1.22, 1.01 to 1.48, 0.14), and chronic pancreatitis (1.27, 0.87 to 1.88, 0.50).
Conclusions
We found that the use of GLP-1 RAs, compared to DPP-4i, were associated with a decreased risk of alcohol misuse and MASLD but not with other chronic liver disease, gallstone, and chronic pancreatitis.
| Original language | English |
|---|---|
| Pages (from-to) | S90-S90 |
| Number of pages | 1 |
| Journal | Value in Health |
| Volume | 28 |
| Issue number | 12, Supplement 1 |
| DOIs | |
| Publication status | Published - 18 Dec 2025 |
| Event | International Society for Pharmacoeconomics and Outcomes Research Conference 2025: Powering Value and Access Through Patient-Centered Collaboration - Scottish Event Campus, Glasgow, United Kingdom Duration: 9 Nov 2025 → 12 Nov 2025 https://www.ispor.org/conferences-education/conferences/past-conferences/ispor-europe-2025 |
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
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SDG 3 Good Health and Well-being
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