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Glucagon-like Peptide 1–Based Drugs and Pancreatic Safety

Glucagon-like Peptide 1–Based Drugs and Pancreatic Safety Letters In their letter, Theuwissen et al raised an interesting point hol use are typically underestimated in claims databases, such that intake of vitamin K may confound the association be- that residual confounding likely persists despite attempts to tween calcium intake and cardiovascular disease and mortal- adjust for these factors. Pancreatitis diagnoses were not con- ity. To explore this possibility, we estimated dietary vitamin firmed through medical chart review but were based on an al- K intake in our study population. We found that vitamin K in- gorithm with positive predictive value stated as 60% to 80%. take was weakly and positively correlated with both dietary Another limitation of this type of analysis is the potential (correlation coefficient, 0.11 in men and 0.10 in women) and for channeling bias, where patients with certain baseline char- supplemental (correlation coefficient, 0.05 in men and 0.05 in acteristicsarepreferentiallyprescribedtreatmentsowingtotheir women) calcium intake (all P < .001). When we further ad- profiles. For example, overweight patients may be preferen- justed for vitamin K intake in the multivariate model used in tially prescribed GLP-1–based therapies owing to the weight loss our study, we observed a negligible change (<1%) in the asso- often associated with these http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Glucagon-like Peptide 1–Based Drugs and Pancreatic Safety

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Publisher
American Medical Association
Copyright
Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2013.8138
pmid
24165844
Publisher site
See Article on Publisher Site

Abstract

Letters In their letter, Theuwissen et al raised an interesting point hol use are typically underestimated in claims databases, such that intake of vitamin K may confound the association be- that residual confounding likely persists despite attempts to tween calcium intake and cardiovascular disease and mortal- adjust for these factors. Pancreatitis diagnoses were not con- ity. To explore this possibility, we estimated dietary vitamin firmed through medical chart review but were based on an al- K intake in our study population. We found that vitamin K in- gorithm with positive predictive value stated as 60% to 80%. take was weakly and positively correlated with both dietary Another limitation of this type of analysis is the potential (correlation coefficient, 0.11 in men and 0.10 in women) and for channeling bias, where patients with certain baseline char- supplemental (correlation coefficient, 0.05 in men and 0.05 in acteristicsarepreferentiallyprescribedtreatmentsowingtotheir women) calcium intake (all P < .001). When we further ad- profiles. For example, overweight patients may be preferen- justed for vitamin K intake in the multivariate model used in tially prescribed GLP-1–based therapies owing to the weight loss our study, we observed a negligible change (<1%) in the asso- often associated with these

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Oct 28, 2013

References