- No overall increased risk: GLP-1 RA initiation was associated with similar 1-year rates of all-cause acute pancreatitis compared with sulfonylureas.
- Opposing cause-specific effects: Increased risk of suspected drug-induced pancreatitis (~+23 per 100,000) was offset by reduced risks of hypertriglyceridemia-associated (~−17) and alcohol-induced (~−10) pancreatitis.
- Time-dependent risk pattern: Drug-induced pancreatitis risk clustered early (first 3 months), while reductions in alcohol- and triglyceride-related pancreatitis emerged later.
- Transient early signal: Overall pancreatitis risk was higher during the first 2 months after initiation, then similar between groups for the remainder of follow-up.
- Clinical implication: Findings support early patient counseling about a small initial risk while recognizing no increase in overall pancreatitis burden at 1 year.
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