Atorvastatin-induced acute pancreatitis

Deshpande, Prasanna R; Khera, Kanav; Thunga, Girish; Hande, Manjunath; Gouda, Siddalingana; Nagappa, Anantha Naik

doi:10.4103/0976-500x.77114

Cited by 9 publications

(8 citation statements)

References 7 publications

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“…However, as one of the HMG-CoA reductase inhibitors group, pravastatin is classified within class I (medications in which at least 1 case report described a recurrence of acute pancreatitis with a rechallenge with the drug). 5 An exhaustive search of the literature revealed only 6 and 5 cases of pancreatitis associated with atorvastatin [6][7][8][9][10][11] and metformin, respectively. [12][13][14][15][16] In most of these cases, drugs were administered for less than a year.…”

Section: Discussionmentioning

confidence: 99%

A Case of Severe Acute Necrotizing Pancreatitis after Administration of Sitagliptin

Sue

Yoshihara

Kuboki

et al. 2013

Clin Med Insights Case Rep

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A 55-year-old Japanese man with a 3-year history of type 2 diabetes mellitus was admitted to our hospital for upper abdominal pain. Control of diabetes mellitus was good with voglibose and metformin, with sitagliptin added to this regimen 8 months prior. His pancreatic enzyme levels were elevated, and abdominal computed tomography (CT) showed diffuse pancreatic swelling with fluid accumulation and ascites of CT grade 3. The patient was diagnosed with severe acute pancreatitis. There were no obvious causes for pancreatitis except the recently administered sitagliptin. Since incretin-related drugs entered the market, the number of incretin-related drugs prescriptions rapidly increased and so did the incidence of pancreatitis. There are several reports suggesting the correlation between incretin-related drugs and pancreatitis, such as a report based on data obtained from the United States Food and Drug Administration (FDA) which revealed a significant correlation between the administration of exenatide or sitagliptin and pancreatitis. However, there also is a report that denied the evidence for such in a large cohort study. The relation between incretin based drugs and pancreatitis is still controversial.

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Section: Discussionmentioning

confidence: 99%

A Case of Severe Acute Necrotizing Pancreatitis after Administration of Sitagliptin

Sue

Yoshihara

Kuboki

et al. 2013

Clin Med Insights Case Rep

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“…Therefore, despite the beneficial effect of atorvastatin in achieving significant levels of TC, LDL cholesterol reduction and significant level of HDL cholesterol elevation , it may lead in some cases to a hepatotoxic effect as occurs with high atorvastatin doses (80 mg/kg), whereas the lower dose (20 mg/kg) seems to cause mild liver injury [65]. Moreover, atorvastatin may induce pancreatitis [66] and cholestasis [67]. Statin-associated myalgia is an important clinical problem that will likely become more prevalent owing to the ever-expanding indications for statin use [68].…”

Section: Rbomentioning

confidence: 99%

Rice Bran Oil Compared to Atorvastatin for Treatment of Dyslipidemia in Patients with Type 2 Diabetes

Shakib¹,

Gabrial²,

Gabrial³

2014

Open Access Maced J Med Sci

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Objective: To compare the effect of rice bran oil versus statins (atorvastatin drug) on blood glucose, glycosylated hemoglobin (HbA1C) and serum lipid profiles in patients with type 2 diabetes. The safety of the tested rice bran oil and atorvastatin were investigated. Fatty acids contents of RBO, olive and sesame oil were also assessed.Materials and Methods: Forty four eligible patients with type 2 diabetes and moderately hyperlipidemic were randomly and equally allocated into two groups, rice bran oil (RBO) group and atorvastatin group. The RBO group received a low-calorie diet and consumed 30 g / day RBO oil as salad dressing and for use as main cooking oil for 6 months. The Atorvastatin group received a low-calorie diet and 40 mg/day of atorvastatin drug for 6 months. At baseline and after 6 months of study intervention, blood glucose, glycosylated hemoglobin (HbA1c), serum lipid profiles; hepatic, renal and inflammatory biomarkers were estimated.Results: Results showed significant increase in fasting and postprandial blood glucose, HbA1C and liver transaminases (alanine transaminase ALT and aspartate transaminase AST) in the atorvastatin group while a significant reduction was shown in RBO group. Moreover, significant reductions in lipid profile levels, blood urea, serum uric acid and erythrocyte sedimentation rate (ESR) were observed in both RBO and atorvastatin groups after 6 months of the study intervention.Conclusion: The use of rice bran oil together with dietary modifications may have implications in lowering fasting and postprandial blood glucose, suppressing serum lipid levels, reduce the TC/HDL-C ratio and therefore reducing the risk of cardiovascular disease. Moreover, RBO exerts a hypouricemic action and anti-inflammatory effects. The findings obtained from the current study reinforce the use of RBO as an alternative natural potent hypolipidemic agent safer than atorvastatin drug that may induce side effects in some cases in patients intolerant to statins

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“…On the other hand, atorvastatin and rosuvastatin, two lipid-modifying agents, have been reported as causative agents in, respectively, six and four hospitalizations, in addition to the occurrence of a positive rechallenge. This association is also well documented [ 31 – 34 ]. Lai and colleagues [ 35 , 36 ] observed in two independent studies an increased risk of pancreatitis in patients with current use of atorvastatin (odds ratio of 1.67) [ 35 ] and rosuvastatin (odds ratio of 3.21) [ 36 ] as compared with those who never used these drugs.…”

Section: Discussionmentioning

confidence: 57%

A Drug-Induced Acute Pancreatitis Retrospective Study

Gagnon

Lavoie

Frigon

et al. 2020

Canadian Journal of Gastroenterology and Hepatology

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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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Atorvastatin-induced acute pancreatitis

Cited by 9 publications

References 7 publications

A Case of Severe Acute Necrotizing Pancreatitis after Administration of Sitagliptin

A Case of Severe Acute Necrotizing Pancreatitis after Administration of Sitagliptin

Rice Bran Oil Compared to Atorvastatin for Treatment of Dyslipidemia in Patients with Type 2 Diabetes

A Drug-Induced Acute Pancreatitis Retrospective Study

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