Letters Safety of GLP-1 drugs

Report all increases in serum amylase in patients starting incretins

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5333 (Published 05 September 2013) Cite this as: BMJ 2013;347:f5333
  1. Zoltán Lengyel, diabetologist1
  1. 1Szent Margit Kórház, Fourth Department of Internal Medicine, 1032, Budapest, Bécsi út 132, Hungary
  1. lengyeldr{at}sztmargit.hu

Cohen recently discussed the potential adverse pancreatic effects of glucagon-like peptide-1 agonists and dipeptidylpeptidase-4 inhibitors.1

Many practising diabetologists have encountered mild asymptomatic increases in amylase activity in patients starting treatment with these drugs. After stopping the treatment this increase usually regresses. Because clinically frank pancreatitis rarely develops, these observations seldom find their way into the adverse event reporting system.

On the basis of pathophysiological considerations and experimental data, incretins have the potential to induce cell growth and proliferation in the islets of Langerhans,2 3 but whether this leads to improvement of β cell function or the development of chronic pancreatitis or pancreatic cancer (or neither) is yet to be seen.

It would be reasonable to measure serum amylase activity in patients starting incretin treatment for some months afterwards and to report all observed increases.


Cite this as: BMJ 2013;347:f5333


  • Competing interests: None declared.


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