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Gastrointestinal safety of incretin therapies: are we there yet?

Nature Reviews Gastroenterology & Hepatology volume 13, pages 630–632 (2016)Cite this article

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The gastrointestinal safety of incretin-based therapies is controversial. Two new studies find no effect of GLP-1 receptor agonists on acute pancreatitis risk, but increased risk of bile duct and gallbladder disease. However, no retrospective epidemiological studies can provide definitive answers, and nausea, vomiting and diarrhoea remain the most clinically relevant adverse effects of these drugs, compromising long-term adherence.

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Figure 1: Potential mechanisms underlying gastrointestinal adverse effects of incretin-based therapies.

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Authors and Affiliations

  1. Juris J. Meier is at the Diabetes Division, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstrasse 56, Bochum, Germany.,

    Juris J. Meier

  2. Julio Rosenstock is at the Dallas Diabetes Research Center at Medical City, 7777 Forest Lane, Suite C-685, Dallas, Texas 75230, USA.,

    Julio Rosenstock

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  1. Juris J. Meier
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Correspondence to Julio Rosenstock.

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Competing interests

J.R. has served on scientific advisory boards and received honorarium or consulting fees from AstraZeneca, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Intarcia, Janssen, Merck, Novo Nordisk and Sanofi. He has received grants and/or research support from Asahi, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly, GlaxoSmithKline, Hanmi, Intarcia, Janssen, Lexicon, MannKind, Merck, Novo Nordisk, Pfizer, Sanofi and Takeda. J.J.M. has received consulting and speaker honoraria from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Merck, Novo Nordisk and Sanofi. He has received research support from Boehringer Ingelheim, Eli Lilly, Merck, Novartis, Novo Nordisk and Sanofi.

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Practical recommendations for the use of GLP-1 receptor agonists in patients with gastrointestinal diseases (PDF 87 kb)

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Meier, J., Rosenstock, J. Gastrointestinal safety of incretin therapies: are we there yet?. Nat Rev Gastroenterol Hepatol 13, 630–632 (2016). https://doi.org/10.1038/nrgastro.2016.149

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