Community Genomic Medicine Center, Department of Medicine, Université de Montréal and ECOGENE-21 biocluster, Chicoutimi, QC, Canada.
Research Center, Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-St-Jean, Chicoutimi, QC, Canada.
Can J Gastroenterol Hepatol. 2020 Nov 3;2020:1516493. doi: 10.1155/2020/1516493. eCollection 2020.
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.
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.
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 ( = 7), followed by atorvastatin ( = 6), hydrochlorothiazide ( = 5), rosuvastatin ( = 4), and codeine ( = 4).
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.
药物被认为是急性胰腺炎（AP）相对罕见且研究较少的病因。由于缺乏关于药物引起的 AP（DIAP）的令人信服和确凿的数据，这使得诊断和确定致病药物变得复杂。本研究旨在记录在萨格奈-圣让湖地区（SLSJ）人群中发生的 DIAP 病例的病因。
我们对 2006 年至 2014 年期间在为整个 SLSJ 人群服务的六家医院发生的 DIAP 病例进行了回顾性和描述性的基于人群的研究。病例从魁北克省卫生部住院登记处（MED-ECHO）行政公共数据库中选择。进行了病历回顾，以尝试描述 DIAP 住院情况并确定可归因的药物。
在所研究期间，共纳入了 75 例（30.7%为男性，69.3%为女性）病例，总计 90 例 DIAP 住院。其中，确定了 50 种致病药物，分布在 17 种不同的药物类别中。在 13 例中记录了复发性 DIAP，其中 6 例经历了阳性再激发试验。6 种药物（5-氟尿嘧啶、阿托伐他汀、硼替佐米、尼洛替尼、瑞舒伐他汀和曲安奈德）具有最高的证据等级。导致 DIAP 住院的最常见药物是硫唑嘌呤（ = 7），其次是阿托伐他汀（ = 6）、氢氯噻嗪（ = 5）、瑞舒伐他汀（ = 4）和可待因（ = 4）。
本研究为文献中潜在的胰腺炎相关药物提供了新的证据。这是第一项报告明确的 5-氟尿嘧啶和曲安奈德诱导的 AP 的研究。需要更新基于证据的文献综述，以支持临床医生确定致病药物。
