The Pharmacological Landscape for Fatty Change of the Pancreas

Abstract

The quest for medications to reduce intra-pancreatic fat deposition is now quarter a century old. While no specific medication has been approved for the treatment of fatty change of the pancreas, drug repurposing shows promise in reducing the burden of the most common disorder of the pancreas. This leading article outlines the 12 classes of medications that have been investigated to date with a view to reducing intra-pancreatic fat deposition. Information is presented hierarchically-from preclinical studies to retrospective findings in humans to prospective interventional studies to randomised controlled trials. This lays the grounds for shepherding the most propitious drugs into medical practice through well-designed basic science studies and adequately powered randomised controlled trials.

Fig. 1

Types of studies that investigated changes in intra-pancreatic fat deposition following the use of medications. ‘Preclinical’ refers to in vivo animal studies. ‘Non-RCT’ refers to retrospective or prospective clinical studies (other than randomised controlled trials). The green tick-box indicates availability of a given type of study in the literature. DPP-4 dipeptidyl peptidase-4, GLP-1 glucagon-like peptide-1, RCT randomised controlled trial, SGLT-2 sodium-glucose cotransporter-2

Fig. 2

Effects of various classes of medications on IPFD. Only major classes of medications are depicted. Classes of medications that have never been demonstrated to affect IPFD are not presented. DPP-4 dipeptidyl peptidase-4, GLP-1 glucagon-like peptide-1, IPFD intra-pancreatic fat deposition, SGLT-2 sodium-glucose cotransporter-2