Elevated Amylase and Lipase Levels in Patients Using Glucagonlike Peptide-1 Receptor Agonists or Dipeptidyl-Peptidase-4 Inhibitors In the Outpatient Setting |
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| Institution: | 1. Department of Medicine, George Washington University, Washington, District of Columbia;2. Medical Specialists of Northern Virginia, Alexandria, Virginia.;1. Eli Lilly and Company, Avenida de la Industria 30, 28108 Alcobendas, Madrid, Spain;2. Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic i Universitari, Carrer de Villarroel 170, 08036 Barcelona, Spain;3. Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Av. de Valdecilla, s/n. 39008, Santander, Spain;4. Jazz Healthcare Italy s.r.l., Italy;5. HaaPACS GmbH, Bahnhofstr. N°19 C, 69198 Schriesheim, Germany;6. Hospital Universitario Quirón Salud, Calle Diego de Velázquez, 1, 28223 Pozuelo de Alarcón, Universidad Europea de Madrid, Madrid, Spain;1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;2. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;3. Center for Drug Safety and Effectiveness, Johns Hopkins University, Baltimore, Maryland;4. Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland;5. Kidney Health Research Institute, Geisinger Health System, Danville, Pennsylvania;6. Division of Nephrology, Tufts Medical Center, Boston, Massachusetts |
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| Abstract: | ObjectiveTo investigate the effects of glucagonlike peptidase-1 (GLP-1) receptor agonists and dipeptidyl-peptidase-4 (DPP-4) inhibitors on serum amylase and serum lipase levels in patients with type 2 diabetes.MethodsIn 90 patients with type 2 diabetes, treatment was initiated with a GLP-1 agonist or a DPP-4 inhibitor. A comparison group consisted of 33 patients with type2 diabetes and similar characteristics who were not prescribed these agents. Baseline serum amylase and lipase levels were measured in all patients and repeated periodically. We determined the percentage of patients with elevated levels of serum amylase or lipase (or both) in both groups.ResultsAmong all 90 patients who received a GLP-1 receptor agonist or a DPP-4 inhibitor, 32 (36%) had an increase in serum amylase or lipase (or both) in comparison with 6 of 33 patients (18%) with such increases in the comparison group. Interestingly, the serum lipase levels increased more than the serum amylase values in all groups. To ascertain that this was not a chance laboratory error, serum samples were submitted to a second independent laboratory, and the same results were obtained. Usually, use of the medication was discontinued when serum lipase or amylase values were found to be elevated at any level.ConclusionBoth GLP-1 receptor agonists and DPP-4 inhibitors are associated with increased levels of serum lipase more than serum amylase in many patients with type2 diabetes, possibly suggesting the presence of pancreatic inflammation. Whether this finding may potentially lead to acute pancreatitis or chronic pancreatitis, as reported in rat models, is currently unknown. Careful observation of patients taking these medications may be prudent. (Endocr Pract. 2012;18:472-477) |
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