Pancreatic Cancer Risk Not Higher With DPP-4 Inhibitors

(HealthDay News) — There is no increased short-term pancreatic cancer risk with dipeptidyl-peptidase-4 (DPP-4) inhibitors compared with sulfonylureas and thiazolidinediones (TZD) for glycemic control, according to a study published in Diabetes, Obesity and Metabolism.

Mugdha Gokhale, from the University of North Carolina at Chapel Hill, and colleagues used Medicare claims data to assess pancreatic cancer risk among patients with no prescriptions for DPP-4 inhibitors, sulfonylureas or TZD at baseline, but had at least two claims for the same drug within 180 days.

In the DPP-4 inhbitors vs. sulfonyulureas comparison, the researchers found that among the 18,179 DPP-4 inhibitor initiators, 26 developed pancreatic cancer (follow-up time interquartile range, 5 to 18 months). In the DPP-4 inhibitors vs. TZD comparison, 52 of the 29,366 DPP-4 inhibitor initiators developed pancreatic cancer. 

With DPP-4 inhibitors, the hazard of pancreatic cancer was lower compared with sulfonylureas (HR=0.6; 95% CI, 0.4-0.9) and similar to TZD (HR=1.0; 95% CI, 0.7-1.4). Results were not altered when the first 6 months of follow-up were excluded to reduce the potential for reverse causality. 

Among DPP-4 inhibitor initiators, the probability of diagnostic work-up post-initiation was similar to TZD (risk ratio=1.06) and sulfonylureas (risk ratio=1.06).

“Though limited by sample size and the observed duration of treatment in the United States, our well-controlled population based study suggests no increased short-term pancreatic cancer risk with DPP-4 inhibitors relative to sulfonylureas or TZD,” the researchers wrote.

Several authors disclosed financial ties to the pharmaceutical industry.


  1. Gokhale M et al. Diab Obes Metab. 2014;doi:10.1111/dom.12379.