Risk of acute pancreatitis with DPP ‐4 inhibitors versus SGLT2 inhibitors in medication‐naïve individuals with diabetes: A target trial emulation
Authors' conclusion
Although small differences cannot be excluded given the width of the CIs for the estimated HRs, the small IRDs observed suggest that any potential difference, if present, is likely to be clinically modest. Therefore, acute pancreatitis risk may not be a major determinant when selecting initial therapy.
Study context
- Population
- Antidiabetic medication-naïve individuals with diabetes, Japanese claims database, April 2014 to August 2023
- Participants
- 26,133 vs 6,497
- Exposure
- DPP-4i vs SGLT2i
- DPP-4in = 26,133
- SGLT2in = 6,497reference
- Outcome
- Hospitalization due to acute pancreatitis
Methodological detailspropensity score-based overlap weighting, Japanese claims database, new-user design
- Propensity score-based overlap weighting
- Japanese claims database
- New-user design
Main finding
As reported in the abstract
DPP-4i vs SGLT2iAdjusted hazard ratio (95% CI)
Intention-to-treat
0.97(0.51–1.83)
Per-protocol
1.11(0.54–2.27)
IRD, per 1000 person-years
- Intention-to-treat
- −0.05 (95% CI −0.97 to 0.87)
- Per-protocol
- 0.15 (95% CI −0.86 to 1.15)
Observational data: associations, not effects.
Original publication
Risk of acute pancreatitis with DPP ‐4 inhibitors versus SGLT2 inhibitors in medication‐naïve individuals with diabetes: A target trial emulation. Diabetes Obes Metab. Published 20 January 2026. doi:10.
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