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Adipose Tissue_Appetite_and Obesity

SUN-731 - Pancreatitis Risk in Patients with Severe Hypertriglyceridemia Treated with GLP-1 Receptor Agonists: A Retrospective Cohort Study

Sunday, June 14, 2026
9:00 AM - 4:00 PM CT
Location: ENDOExpo; Poster Floor

    Abstract Poster Presenter(s)

  • Usheem Syed, MBBS (she/her/hers)

    Fellow
    UNIVERSITY OF CONNECTICUT
    Hartford, CT, United States

    • Senior Author/Primary Investigator(s)

  • PM

    Parvathy Madhavan, MD

    Assistant Professor of Medicine
    University of Connecticut Health Center
    Farmington, Connecticut, United States

Disclosure(s):
Usheem Syed, MBBS: No financial relationships to disclose


Objective: Patients with severe hypertriglyceridemia (TG >500 mg/dL) are at increased baseline risk for pancreatitis. GLP-1 receptor agonists (GLP-1RA) carry warnings for pancreatitis, but real-world data in patients with severe hypertriglyceridemia are limited. We evaluated pancreatitis incidence among patients with TG >500 mg/dL treated with GLP-1RA therapy compared with those not receiving GLP-1RA.

Methods: We conducted a retrospective cohort study using Epic SlicerDicer at a tertiary academic medical center from 11/2022–10/2025. Adults with triglycerides >500 mg/dL were included. Exposure was treatment with any GLP-1RA (semaglutide, tirzepatide, dulaglutide, or liraglutide). The primary outcome was pancreatitis (acute, recurrent, idiopathic, or drug-induced). Absolute risk (AR) was calculated, and GLP-1RA users were compared with non-users using risk ratio (RR) and odds ratio (OR).

Results: Eighty-five patients met inclusion criteria. 28 received a GLP-1RA (semaglutide n=18, tirzepatide n=8, dulaglutide n=1, liraglutide n=1), and 57 received no GLP-1RA. Pancreatitis occurred in 1/28 GLP-1RA users (AR 3.6%) and 2/57 non-users (AR 3.5%). The RR for pancreatitis with GLP-1RA use was 1.03 and the OR was 1.03. No pancreatitis events occurred among patients treated with tirzepatide, dulaglutide, or liraglutide; the single GLP-1RA–associated event occurred in a semaglutide user. Overall event rates were low, and subgroup analyses by age, sex, diabetes status, or triglyceride severity were limited by small numbers.

Conclusion: In patients with triglycerides >500 mg/dL, pancreatitis was uncommon and occurred at similar rates among GLP-1RA users and non-users. These findings do not suggest an increased pancreatitis risk associated with GLP-1RA therapy in this high-risk population. Larger studies are needed to further define safety across GLP-1RA agents in patients with severe hypertriglyceridemia.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*