{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:36:13Z","timestamp":1780734973509,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 109\u20102314\u2010B\u2010002\u2010153\u2010MY2"],"award-info":[{"award-number":["MOST 109\u20102314\u2010B\u2010002\u2010153\u2010MY2"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objective<\/jats:title><jats:p>Clinical trials have suggested that glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RAs) may be associated with a higher risk of biliary\u2010related diseases in patients with type 2 diabetes. Limited real\u2010world studies have examined the comparative biliary safety of GLP\u20101RAs versus other antihyperglycemic drugs. We aimed to estimate the comparative risk of biliary\u2010related diseases between GLP\u20101RAs and sodium glucose cotransporter 2 inhibitors (SGLT2is), which are indicated for patients with similar diabetes severity in Taiwan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Source<\/jats:title><jats:p>Taiwan National Health Insurance Database during 2011 to 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Patients with type 2 diabetes who initiated GLP\u20101RAs or SGLT2is.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>GLP\u20101RAs versus SGLT2is.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>We used an on\u2010treatment approach to examine the effect of continuous use and an intention\u2010to\u2010treat approach to assess the effect of initiation of GLP\u20101RAs versus SGLT2is. We used Coxregression models to estimate the hazard ratios (HRs) and 95% confidenceintervals (CIs) for the composite hospitalized biliary\u2010related diseases, including acute cholecystitis or cholecystectomy, choledocholithiasis, and acute cholangitis, after matching each GLP\u20101RA initiator to up to 10 SGLT2iinitiators using propensity scores (PSs). Among 78,253 PS\u2010matched patients, GLP\u20101RA use was associated with a numerically higher risk of biliary\u2010related diseases versus SGLT2i use in the on\u2010treatment analysis, with an HR of 1.20 (95% CI, 0.93\u20131.56) for the composite outcome, an HR of 1.22 (95% CI, 0.92\u20131.62) for acute cholecystitis or cholecystectomy, an HR of 1.20 (95% CI, 0.69\u20132.07) for choledocholithiasis, and an HR of 1.14 (95% CI,0.82\u20132.42) for acute cholangitis. The HRs were more pronounced in theintention\u2010to\u2010treat analysis (1.27 [95% CI, 1.05\u20131.53] for the composite outcome, 1.29 [95% CI, 1.04\u20131.58] foracute cholecystitis or cholecystectomy, 1.74 [95% CI, 1.23\u20132.46] for choledocholithiasis, and 1.31 [95% CI, 0.89\u20131.94] for acute cholangitis). The increased risk of the composite outcome associated with GLP\u20101RAs was more evident in patients aged \u232a60 years, women, and 120 days after treatment initiation. Liraglutide, but not dulaglutide, was associated with an elevated risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>GLP\u20101RAs might be associated with an elevated risk of biliary\u2010related diseases compared to SGLT2is in Asian patients with type 2 diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2688","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T22:14:40Z","timestamp":1651702480000},"page":"483-494","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Association between glucagon\u2010like peptide\u20101 receptor agonists and biliary\u2010related diseases in patients with type 2 diabetes: A\u00a0nationwide cohort study"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0748-7993","authenticated-orcid":false,"given":"Yaa\u2010Hui","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Pharmacy, College of Pharmaceutical Sciences National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Institute of Public Health, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Institute of Hospital and Health Care Administration, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9435-746X","authenticated-orcid":false,"given":"Jo\u2010Hsuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Shiley Eye Institute and Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center University of California  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Hsuin","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Department of Medicine, College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Institute of Epidemiology and Preventive Medicine, College of Public Health National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jou\u2010Wei","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Department of Internal Medicine National Taiwan University Hospital Yunlin Branch  Douliou City Taiwan"},{"name":"Cardiovascular Center National Taiwan University Hospital Yunlin Branch  Douliou City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Chiu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sengwee","family":"Toh","sequence":"additional","affiliation":[{"name":"Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.08.063"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2015.11.012"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2018.03.001"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603827"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-0415"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12926"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12373"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.1531"},{"key":"e_1_2_8_10_1","unstructured":"UpToDate\u00ae.Gallstones: epidemiology risk factors and prevention. 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