Abstract
Background and Objectives: Sitagliptin is a dipepidyl peptidase inhibitor (DPP-4i) with gentle antidiabetic effects with a lower risk of hypoglycemia. The association with acute pancreatitis is controversial. The current meta-analysis aimed to assess the relationship of sitagliptin and acute pancreatitis.
 Methods: The literature in PubMed and Google Scholar was searched for relevant articles published in the last ten years up to September 2021. The keywords sitagliptins, DPP-4i, acute pancreatitis were used with the protean AND or OR. Among the 204 articles retrieved, 24 full-texts were assessed for eligibility and only five studies (Three from the USA, one from Asia, and one from Canada) met the inclusion criteria for the systematic review. The author name, year of publication, country, type of study, number of patients, and the duration of the study were reported.
 Results: There were five studies. The total number of patients were 729808 with 6459 events. The studies showed no increased rate of acute pancreatitis following sitagliptin use, odd ratio, 0.79, 95% CI, 0.29-2.15, a significant heterogeneity was observer, I2 for heterogeneity=98%, P-value, <001, the P-value for overall effect was 0.65 and the chi-square, 160.15.
 Interpretation and Conclusion: Sitagliptin use is not associated with acute pancreatitis.
Highlights
Sitagliptin is one of the dipeptidyl peptidase inhibitors (DPP-4i) a class of oral hypoglycemic medications with a lower propensity for hypoglycemia, moderate hypoglycemic efficacy, and weight neutral effect, the drugs are available as oral products alone or in combination with metformin or sodium-glucose co-transporters inhibitors with a large market share [1]
DPP-4i are blamed for many side effects including admission for heart failure with saxagliptin, and aspiration pneumonia due to the degradation of substance P [2, 3], the association of DPP-4 and acute pancreatitis is a matter of controversy [4, 5]
The studies showed no increased rate of acute pancreatitis following sitagliptin use, odd ratio, 0.79, 95% CI, 0.29-2.15, a significant heterogeneity was observer, I2 for heterogeneity=98%, P-value,
Summary
Sitagliptin is one of the dipeptidyl peptidase inhibitors (DPP-4i) a class of oral hypoglycemic medications with a lower propensity for hypoglycemia, moderate hypoglycemic efficacy, and weight neutral effect, the drugs are available as oral products alone or in combination with metformin or sodium-glucose co-transporters inhibitors with a large market share [1]. Acute pancreatitis is a condition where the pancreas becomes inflamed (swollen) over a short period of time. It is a morbid disease with a high rate of mortality depending on severity, it may constitute up to 3% of admission to surgery [6]. The available reviews are mostly on DPP-4i, the literature on the individual drugs and pancreatitis are scarce. We conducted this review to assess the relationship between sitagliptin and acute pancreatitis. The studies showed no increased rate of acute pancreatitis following sitagliptin use, odd ratio, 0.79, 95% CI, 0.29-2.15, a significant heterogeneity was observer, I2 for heterogeneity=98%, P-value, Mirghani et al.; JPRI, 33(50B): 45-50, 2021; Article no.JPRI.76970
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