There is no increased short-term pancreatic cancer risk with dipeptidyl-peptidase-4 inhibitors (DPP-4i) compared to sulfonylureas (SU) 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-4i, SU, or TZD at baseline, but had at least two claims for the same drug within 180 days.

In the DPP-4i versus SU comparison, the researchers found that among the 18,179 DPP-4i initiators, 26 developed pancreatic cancer (follow-up time interquartile range, five to 18 months). In the DPP-4i versus TZD comparison, 52 of the 29,366 DPP-4i initiators developed pancreatic cancer.

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With DPP-4i, the hazard of pancreatic cancer was lower compared to SU (hazard ratio, 0.6; 95 percent confidence interval, 0.4 to 0.9) and similar to TZD (hazard ratio, 1.0; 95 percent confidence interval, 0.7 to 1.4).

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Results were not altered when the first six months of follow-up were excluded to reduce the potential for reverse causality. Among DPP-4i initiators, the probability of diagnostic work-up post-initiation was similar to TZD (risk ratio, 1.06) and SU (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-4i relative to SU or TZD,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.


  1. Gokhale, M., et al. “Dipeptidyl-peptidase-4 inhibitors and pancreatic cancer: a cohort study.” Diabetes, Obesity and Metabolism. DOI: 10.1111/dom.12379. September 10, 2014.