Drug-induced pancreatitis: Study of 38 patients

Abstract

Introduction

Acute pancreatitis (AP) is an inflammatory disease with multiple etiologies, and the emergence of complications. Between 0.1%–5% of cases are attributed to drugs. The absence of specific characteristics complicates the diagnosis and treatment of drug-induced AP. Reviewing patients admitted with the diagnosis of drug-induced AP can provide information and improve its management.

Patients and methods

This is a descriptive, observational, and retrospective study. All patients admitted to the Hospital Universitari de Bellvitge (HUB) between June 2007 and March 2023 with suspected drug-induced AP were included. The data were obtained from the HUB pharmacovigilance program database.

Results

Thirty-eight patients with suspected drug-induced AP were identified, representing 0.62% of all adverse drug reactions (ADRs) (n = 6085). Of these, 65.8% (n = 25) had a single suspected drug. The median latency period for the onset of ADRs was 160.5 days (IQR 18–582 days), and the median hospital stay was 5 days (IQR 3–7 days). Fifty-nine suspected drugs were identified, involving 26 active principles. Azathioprine and atorvastatin were the most frequent, with 9 cases each (15.2%), followed by enalapril with 8 cases (13.6%). Drug etiology was assessed in 23 cases (60.5%), and the suspected drug was discontinued in all cases. There was 1 fatal case documented (2.63%).

Conclusion

This study can contribute to better understanding of drug-induced pancreatitis episodes. We propose the creation of a diagnostic algorithm that includes the assessment of the drug as a possible cause.