Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 22;16(11):e74245.
doi: 10.7759/cureus.74245. eCollection 2024 Nov.

Increasing Trends in the Pancreatitis Risk With Tumor Necrosis Factor Inhibitor Use

Joyce H Gu  1 , Mark Samarneh  2
Affiliations

Increasing Trends in the Pancreatitis Risk With Tumor Necrosis Factor Inhibitor Use

Joyce H Gu et al. Cureus. .

Abstract

Tumor necrosis factor (TNF) inhibitors are a class of pharmacologic agents used to treat a wide range of immunologic diseases. We present a systematic study of the pancreatitis risk with TNF inhibitor use through a retrospective case-control design disproportionality analysis of the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database, with data ranging from the fourth quarter of 2012 (2012 Q4) to the second quarter of 2024 (2024 Q2). Our analysis reveals an increasing trend in the pancreatitis risk with TNF inhibitors when stratified by year, with all of the TNF inhibitors studied exhibiting significant association with pancreatitis in the year 2023. Furthermore, these results hold even when controlling for sex, age, concurrent use of azathioprine, and the indication for treatment. Our findings flag the necessity for a careful investigation and monitoring of pancreatitis risk in patients undergoing TNF inhibitor therapy, especially in recent years.

Keywords: disproportionality analysis; food and drug administration adverse event reporting system (faers); medication-induced pancreatitis; pharmacovigilance; tnf alpha inhibitor.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. ROR of the association between pancreatitis and TNF inhibitors
ROR: reporting odds ratio; TNF: tumor necrosis factor When plotted across years from 2013 to 2023, there is a clear increasing trend in many TNF inhibitors.
Figure 2
Figure 2. ROR of the association between pancreatitis and TNF inhibitors
ROR: reporting odds ratio; TNF: tumor necrosis factor; AZA: azathioprine; 6MP: 6-mercaptopurine The increasing trend in the pancreatitis risk with TNF inhibitors persists after stratification by sex, age, and AZA/6MP usage.
Figure 3
Figure 3. ROR of the association between pancreatitis and TNF inhibitors
ROR: reporting odds ratio; TNF: tumor necrosis factor The increasing trend in the pancreatitis risk of TNF inhibitors persists after stratification by the indication for TNF inhibitor treatment.
See this image and copyright information in PMC

References

    1. Tumor necrosis factor antagonist mechanisms of action: a comprehensive review. Tracey D, Klareskog L, Sasso EH, Salfeld JG, Tak PP. Pharmacol Ther. 2008;117:244–279. - PubMed
    1. Tumor necrosis factor inhibitors - state of knowledge. Lis K, Kuzawińska O, Bałkowiec-Iskra E. Arch Med Sci. 2014;10:1175–1185. - PMC - PubMed
    1. Managing inadequate response to initial anti-TNF therapy in rheumatoid arthritis: optimising treatment outcomes. Taylor PC, Matucci Cerinic M, Alten R, Avouac J, Westhovens R. Ther Adv Musculoskelet Dis. 2022;14 - PMC - PubMed
    1. Is there a best first line biological/small molecule in IBD: are we ready for sequencing? Hahn GD, Golovics PA, Wetwittayakhlang P, Al Khoury A, Bessissow T, Lakatos PL. Biomedicines. 2022;10:749. - PMC - PubMed
    1. The role of tumor necrosis factor alpha (TNF-α) in autoimmune disease and current TNF-α inhibitors in therapeutics. Jang DI, Lee AH, Shin HY, et al. Int J Mol Sci. 2021;22:2719. - PMC - PubMed

LinkOut - more resources