Metformin pancreatitis

Discussion in 'Northwestpharmacy' started by crim, 19-Aug-2019.

  1. osenb XenForo Moderator

    Metformin pancreatitis


    Acute pancreatitis (AP) is a heterogeneous disease ranging from a clinically mild form to a more severe forms associated with high morbidity and mortality (78). A correct diagnosis of AP should be made within 48 h of admission. Understanding of the etiology and severity assessment are essential, as they may affect the acute management of the disease (8). The most common etiology for AP are gallstones and alcohol abuse. post-ERCP), metabolic and autoimmune disorders, inherited disorders, neoplasia (even intraductal papillary mucinous neoplasia- IPMN), anatomical abnormalities, infections, ischaemia, trauma and drugs (87). Additional investigations after recovery from the acute episode are recommended in patients with an episode of AP classified as idiopathic (68). Drugs may be considered a potential cause of the disease in patients who take medications that have been associated with AP. Drug-induced pancreatitis (DIP) is assumed to be a relative rare entity, and its incidence is reported between 0.1 and 2% of AP cases (62). A drug widely used to treat type 2 diabetes may have unintended effects on the pancreas that could lead to a form of low-grade pancreatitis in some patients and a greater risk of pancreatic cancer in long-term users. Sitagliptin, sold in pill form as Januvia, caused abnormalities in the pancreas that are recognized as risk factors for pancreatitis and, with time, pancreatic cancer in humans. Sitagliptin is a member of a new class of drugs that enhance the actions of the gut hormone known as glucagon-like peptide 1 (GLP-1), which has been shown to be effective in lowering blood sugar in people with Type 2 diabetes. A drug widely used to treat Type 2 diabetes may have unintended effects on the pancreas that could lead to a form of low-grade pancreatitis in some patients and a greater risk of pancreatic cancer in long-term users, UCLA researchers have found. Hillblom Islet Research Center at UCLA found that sitagliptin, sold in pill form as Januvia, caused abnormalities in the pancreas that are recognized as risk factors for pancreatitis and, with time, pancreatic cancer in humans. "Type 2 diabetes is a lifelong disease — people often take the same drugs for many years, so any adverse effect that could over time increase the risk for pancreatic cancer would be a concern," said Dr. Peter Butler, director of the Hillblom Center and the study's lead investigator. "A concern here is that the unwanted effects of this drug on the pancreas would likely not be detected in humans unless the pancreas was removed and examined." An observed connection between Byetta, a drug used to treat Type 2 diabetes that is related to Januvia in its intended actions, and pancreatitis has already been reported, prompting a Food and Drug Administration warning. Amylin Corp., which markets Byetta, has suggested that since there is no known mechanism linking the cases of pancreatitis with Byetta, the association might be chance. The UCLA study suggests that there may indeed be a link between drugs that enhance the actions of GLP-1 and pancreatitis — by increasing the rate of formation of cells that line the pancreatic ducts.

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    Drug-induced pancreatitis DIP is assumed to be a relative rare. Mallick S. Metformin induced acute pancreatitis precipitated by renal failure. Metformin-Induced Pancreatitis. A possible adverse drug effect during acute renal failure. Filippo Luca Fimognari, MD12,; Andrea Corsonello, MD3,; Ruggero. Keywords Metformin; Celecoxib; Candesartan; Lactic acidosis; Acute kidney injury; Pancreatitis. Introduction. Polypharmacy is not uncommon in patients with.

    Aims: This study is to systematically investigate the relationship between metformin and risk of pancreatic cancer in patients with type 2 diabetes mellitus. Methods: A systematic literature search was performed on Pub Med, Embase, Cochrane Library, Highwire, CBM, CNKI, Wanfang, VIP databases. Cohort or case control studies of metformin and risk of pancreatic cancer in patients with type 2 diabetes mellitus were included. The Newcastle-Ottaua Scale score was used for quality evaluation and meta-analysis was performed using Rev Man5.2 Meta-analysis software. The results showed that the risk of pancreatic cancer was significantly reduced in metformin treatment group (RR=0.61, 95% CI (0.55, 0.67), P We included studies that met the following criteria: 1) published studies on the relationship between metformin and pancreatic cancer in T2DM patients; 2) similar study aims and statistical methods with complete data; and 3) cohort study or case-control study. In the cohort study, the metformin group was treated with metformin, and the control group was treated with other antidiabetic drugs (including sulfonylureas, thiazolidinediones, or insulin). In the case-control study, case group were T2DM patients with pancreatic cancer, control group were T2DM patients without pancreatic cancer, and exposure was metformin. We excluded studies that met the following criteria: 1) flawed study design flaws with incomplete data; 2) exposure factors were not metformin; 3) no evaluation of relationship between metformin and pancreatic cancer; or 4) duplicates. Metformin is a biguanide commonly used in type 2 diabetes and considered to be a safe drug with minimal side effects. Approximately 2% of cases of acute pancreatitis may be caused by drugs, but it is not a known complication of metformin therapy. To date only one case of pancreatitis has been reported in association with metformin, but that was secondary to metformin poisoning (overdose). This is the first reported case of pancreatitis caused by a therapeutic dose of metformin (although in this case renal failure precipitated the metformin toxicity). Severe lactic acidosis is a rare but life threatening complication of metformin, which occurs particularly in patients with renal failure. A 61 year old woman presented to the emergency department with a history of vomiting for four days and abdominal pain for one day. Her medical history included type 2 diabetes, ischaemic heart disease, and previous myocardial infarction, and regular medications included aspirin, atenolol, clopidogrel, amlodipine, lisinopril, nitrate, metformin, nateglinide, and ibuprofen.

    Metformin pancreatitis

    The effect of metformin on survival of patients with pancreatic cancer a., Metformin-Induced Pancreatitis Diabetes Care

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  4. Popular Diabetes Treatment Could Trigger Pancreatitis, Pancreatic Cancer. But the metformin, trade name Glucophage, seems to counteract.

    • Popular Diabetes Treatment Could Trigger Pancreatitis, Pancreatic..
    • Metformin-induced lactic acidosis and acute pancreatitis precipitated..
    • Metformin induced acute pancreatitis and lactic acidosis in a patient..

    Investigators may have uncovered a novel mechanism behind the ability of the diabetes drug metformin to inhibit the progression of pancreatic. Diabetic rats were given sitagliptin, metformin, or a combination of both drugs. Rats given sitagliptin had problems in their pancreas – enlargement, pancreatitis. Objective To report a case of metformin-associated exacerbation of chronic pancreatitis and examine this possible drug-disease interaction. Case Summary A.

     
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