Abstract
<title>Abstract</title> <p>Background Comparative evidence for glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2Is) in chronic pancreatitis is limited. We compared outcomes between these therapies. Methods This retrospective TriNetX database study included adults with diabetes and chronic pancreatitis receiving a GLP-1 RA or SGLT2I. Propensity score matching yielded 3373 patients per cohort. Outcomes were assessed from day 1 through day 1825. Risk ratios (RRs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated. Results Recurrent acute pancreatitis occurred in 4.7% of GLP-1 RA recipients and 7.2% of SGLT2I recipients (RR, 0.649; 95% CI, 0.488–0.863; HR, 0.586; 95% CI, 0.437–0.786). GLP-1 RA use was also associated with lower recorded risks of exocrine pancreatic insufficiency (2.4% vs 4.7%; RR, 0.495; 95% CI, 0.374–0.657; HR, 0.473; 95% CI, 0.355–0.630), malnutrition (4.7% vs 7.6%; RR, 0.616; 95% CI, 0.499–0.760; HR, 0.601; 95% CI, 0.484–0.746), and all-cause mortality (8.7% vs 12.5%; RR, 0.697; 95% CI, 0.605–0.803; HR, 0.680; 95% CI, 0.586–0.790). No significant differences were observed for pancreatic pseudocyst, abnormal weight loss, pancreatic cancer, or subsequent opioid use. Conclusions GLP-1 RA use was associated with lower recorded risks of recurrent acute pancreatitis, exocrine pancreatic insufficiency, malnutrition, and mortality than SGLT2I use.</p>