After PSM, GLP-1 RA use was associated with a substantially lower risk of all-cause death (HR 0.554, 95% CI 0.542–0.566), and small increased risk of the composite outcome (HR 1.062, 95% CI 1.023–1.102) and acute pancreatitis (HR 1.058, 95% CI 1.015–1.103), with no differences in chronic pancreatitis or pancreatic cancer. Here, GLP1R is linked to familial pancreatic carcinoma.