Abstract
Disclosure: A. Kang: None. R. Devbhandari: None.
Hypertriglyceridemia is a known risk factor for pancreatitis and management involves pursuing lifestyle modifications and lipid lowering agents such as statins and fibrates. Glucagon-like-peptide-1 (GLP-1) analogs are a class of medications that can be used to treat obesity and work by promoting insulin secretion following a glucose load. Acute pancreatitis has been reported by some users of GLP-1 analogs and their use in patients with prior history of pancreatitis has been discouraged, although it is unclear whether there is a causal relationship. This study aimed to compare the outcomes of GLP-1 agonists and lipid lowering agents in patients with hypertriglyceridemia. We utilized the TrinetX health research network to analyze the records of patients with hypertriglyceridemia. There were 21,106 patients receiving treatment with a GLP-1 analog (Cohort A) and 296,961 patients taking lipid lowering agents which we defined as atorvastatin, rosuvastatin, pravastatin, simvastatin, fenofibrate, ezetimibe, icosapent ethyl, evolocumab (Cohort B). Our analysis focused on incidence of acute pancreatitis, mortality, and lipid panel values. Propensity score matching was performed to account for differences in demographics. The incidence of acute pancreatitis in hypertriglyceridemia was significantly lower (1.2%) in the GLP-1 agonist group compared to (5.6%) in the lipid lowering group (RR 0.208, p-value <.0001). Survival probability was higher (95.90%) in the GLP-1 agonist group compared to (85.54%) in the lipid lowering group (HR 0.396, p-value 0.002). There were no significant differences in laboratory data for total cholesterol, triglycerides, LDL, or thyroid function. Our study indicates that GLP-1 analogs pose a significantly reduced risk for acute pancreatitis compared to established lipid lowering agents. These findings suggest that a history of pancreatitis may not be a contraindication to GLP-1 agonist use in patients who have severe obesity and hypertriglyceridemia. Furthermore, it may reduce mortality for patients who have failed other modalities for weight loss, which is consistent with our findings. Ongoing research is essential to understand the long-term outcomes of GLP-1 analog therapy.
Presentation: Sunday, July 13, 2025