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. 2020 Nov 3:2020:1516493.
doi: 10.1155/2020/1516493. eCollection 2020.

A Drug-Induced Acute Pancreatitis Retrospective Study

Ann-Lorie Gagnon  1   2 , Alexandre Lavoie  3 , Marie-Pier Frigon  1   2 , Alban Michaud-Herbst  4 , Karine Tremblay  1   2   5
Affiliations

A Drug-Induced Acute Pancreatitis Retrospective Study

Ann-Lorie Gagnon et al. Can J Gastroenterol Hepatol. .

Abstract

Background and aims: Drugs are considered a relatively rare and understudied cause of acute pancreatitis (AP). The lack of convincing and conclusive data on drug-induced AP (DIAP) complicates the diagnosis as well as the identification of the causative drug. The aim of this study is to document causes of DIAP cases that occurred in the Saguenay-Lac-Saint-Jean (SLSJ) population.

Methods: We have conducted a retrospective and descriptive population-based study of DIAP cases that occurred between 2006 and 2014 in the six hospitals serving the entire SLSJ population. Cases were selected from the Quebec Ministry of Health hospitalizations registry (MED-ECHO) administrative public database. A medical chart review was performed in an attempt to characterize DIAP hospitalizations and to identify the imputable drugs.

Results: During the studied period, 75 cases (30.7% male, 69.3% female) were included totaling 90 hospitalizations for DIAP. Among them, 50 causative drugs were identified and were distributed in 17 different drug classes. Recurrent DIAPs were documented in 13 cases, and among them, 6 cases have experimented a positive rechallenge. Six drugs (5-fluorouracil, atorvastatin, bortezomib, nilotinib, rosuvastatin, and triamcinolone) were associated with the highest degree of evidence. The most common causative drugs of DIAP hospitalization were azathioprine (n = 7), followed by atorvastatin (n = 6), hydrochlorothiazide (n = 5), rosuvastatin (n = 4), and codeine (n = 4).

Conclusions: This study has added new evidences about potentially pancreatitis-associated drugs in literature. This is the first study to report definite 5-fluorouracil- and triamcinolone-induced AP. An updated version of the evidence-based literature review is needed to support the clinicians in the identification of the causative drugs.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Schematic representation of the data sorting process. Flow chart representing the number of cases included in the study.
Figure 2
Figure 2
Distribution of drug-induced acute pancreatitis causative drug classes. Presented as percent according to the number of hospitalizations (n = 90). ∗Others included psycholeptics, endocrine therapy, and antimycobacterials drug classes.
See this image and copyright information in PMC

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