Should patients on GLP-1 Receptor Agonists and DPP-4 Inhibitors be periodically tested forserum amylase and/or lipase???
A study recently published in Endocrine Practice indicates that it might be a good idea test patients forserum amylase and/or lipase to detect early signs of pancreatic inflammation.
Title of the study:
"Elevated Amylase and Lipase in Patients Using GLP-1 Receptor Agonists or DPP-4 Inhibitors in the Outpatient Setting"
Authors of the study:Howard M Lando, MD, FACP, FACE, 1Department of Medicine, George Washington University, Washington, DC, Medical Specialists of Northern Virginia, Alexandria, VA, May Alattar, MD, MBBCh Medical Specialists of Northern Virginia, Alexandria, VA, Anuradha P Dua, MD Medical Specialists of Northern Virginia, Alexandria, VA
This study investigated the” effects of GLP-1 receptor agonists and DPP-4 inhibitors on serum amylase and lipase in patients with type 2 diabetes.” Ninety patients “with type 2 diabetes were started on a GLP-1 agonist or a DPP-4 inhibitor. “ There was a comparison group of 33 patients who were not on GLP-1 receptor agonists and DPP-4 inhibitors. “Baseline serum amylase and lipase levels were obtained in all patients and repeated periodically.”
Thirty two out of 90 patients (35.6%) who received a GLP-1 receptor agonist or a DPP-4 inhibitor had an increase in serum amylase and/or lipase. Six out of 32 patients (18%) in the comparison group of patients had an increase in serum amylase and/or lipase. It was noted also that “serum lipase levels increased more than serum amylase in all groups.” These lab studies were repeated twice to be sure they were not lab errors.” Usually, medication was discontinued when lipase or amylase values were found to be elevated at any level”.
The investigators concluded that ”both GLP-1 agonists and DPP-4 inhibitors are associated with increased serum lipase more than serum amylase in many patients with type 2 diabetes possibly suggesting pancreatic inflammation. Whether this may potentially lead to acute pancreatitis or chronic pancreatitis as reported in rat models remains a question. Careful observation of patients taking these medications may be required.”
The study was Published in Endocrine Practice, a publication of the American Association of Clinical Endocrinologists, Monday, 02/20/2012, pages 1-16