TOPLINE:

In a retrospective, propensity score-matched cohort of patients with chronic pancreatitis, the use of GLP‑1 receptor agonists was associated with approximately 41% and 42% lower hazards of initiating chronic opioid therapy and developing opioid use disorder over a span of 3 years, respectively, with roughly 49%-56% lower hazards of requiring invasive pancreatic interventions.

METHODOLOGY:

• Chronic pancreatitis is a debilitating inflammatory disease marked by irreversible glandular destruction and intractable pain; although GLP‑1 receptor agonists have shown anti‑inflammatory effects in preclinical studies, their clinical effect in pancreatitis remains unexplored.
• Researchers conducted a retrospective cohort study using a US-based clinical research database to study the association between GLP‑1 receptor agonist use and the risk for chronic opioid use, opioid use disorder, and invasive pancreatic interventions in adults (≥ 18 years) with chronic pancreatitis identified using diagnostic codes for alcohol‑induced chronic pancreatitis and other types of chronic pancreatitis.
• After propensity score matching, each cohort included 10,625 patients (mean age, 59.6 years; 53.7% female); those prescribed GLP‑1 receptor agonists (dulaglutide, semaglutide, or tirzepatide) were compared with control individuals who did not receive these agents.
• The mean observation period for the GLP-1 cohort was 600.3 days and was 716.7 days for the control cohort.
• The primary outcomes were assessed over a 3-year observation window and included chronic opioid prescriptions, opioid use disorder, celiac plexus block or neurolysis, endoscopic pancreatic interventions, and major pancreatic surgery.

TAKEAWAY:

• Patients receiving GLP-1 receptor agonists demonstrated a 41% lower hazard of initiating chronic opioids than those in the control group (hazard ratio [HR], 0.588; P < .001), with the 3-year probability of remaining free from chronic opioid prescriptions being 93.70% and 90.44%, respectively.
• The risk of developing opioid use disorder was reduced by 42% in the GLP-1 cohort (HR, 0.577; P < .001), with the 3-year probability of remaining disorder-free being 97.08% among GLP-1 receptor agonist users and 94.82% in control individuals.
• GLP-1 receptor agonist therapy was associated with a 49% reduction in the hazard of requiring a celiac plexus block or neurolysis (HR, 0.511; P = .001) and a 52% reduction in the requirement for endoscopic pancreatic interventions (HR, 0.475; P < .001).
• The risk of undergoing major pancreatic surgery was 56% lower in the GLP-1 cohort (HR, 0.443; P < .001), with the 3-year probability of avoiding major surgery being 99.17% in the GLP-1 cohort and 98.24% in the control cohort.

IN PRACTICE:

“These findings suggest that GLP-1 RAs [receptor agonists] may have a role in the multidisciplinary management of selected patients with CP [chronic pancreatitis] and concomitant diabetes or obesity,” the authors of the study wrote.

SOURCE:

The study was led by Arkadeep Dhali, Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England, and Rick Maity, School of Medical Science and Technology, Indian Institute of Technology Kharagpur, Kharagpur, India. It was published online in Gastro Hep Advances.

LIMITATIONS:

All variables used in the study were derived from routinely collected electronic health records and diagnostic codes. Residual confounding could not be excluded, particularly regarding disease severity, etiology, genetic mutations, lifestyle factors, socioeconomic status, and center-level practice patterns. The study could not reliably assess medication adherence, treatment duration, the exact GLP-1 dosing, or the specific prescribing indication for GLP-1 therapy.

DISCLOSURES:

The study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declared having no potential conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.