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Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations

OBJECTIVE: A current assessment of case reports of possible drug-induced pancreatitis is needed. We systematically reviewed the case report literature to identify drugs with potential associations with acute pancreatitis and the burden of evidence supporting these associations. METHODS: A protocol w...

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Autores principales: Wolfe, Dianna, Kanji, Salmaan, Yazdi, Fatemeh, Barbeau, Pauline, Rice, Danielle, Beck, Andrew, Butler, Claire, Esmaeilisaraji, Leila, Skidmore, Becky, Moher, David, Hutton, Brian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164626/
https://www.ncbi.nlm.nih.gov/pubmed/32302358
http://dx.doi.org/10.1371/journal.pone.0231883
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author Wolfe, Dianna
Kanji, Salmaan
Yazdi, Fatemeh
Barbeau, Pauline
Rice, Danielle
Beck, Andrew
Butler, Claire
Esmaeilisaraji, Leila
Skidmore, Becky
Moher, David
Hutton, Brian
author_facet Wolfe, Dianna
Kanji, Salmaan
Yazdi, Fatemeh
Barbeau, Pauline
Rice, Danielle
Beck, Andrew
Butler, Claire
Esmaeilisaraji, Leila
Skidmore, Becky
Moher, David
Hutton, Brian
author_sort Wolfe, Dianna
collection PubMed
description OBJECTIVE: A current assessment of case reports of possible drug-induced pancreatitis is needed. We systematically reviewed the case report literature to identify drugs with potential associations with acute pancreatitis and the burden of evidence supporting these associations. METHODS: A protocol was developed a priori (PROSPERO CRD42017060473). We searched MEDLINE, Embase, the Cochrane Library, and additional sources to identify cases of drug-induced pancreatitis that met accepted diagnostic criteria of acute pancreatitis. Cases caused by multiple drugs or combination therapy were excluded. Established systematic review methods were used for screening and data extraction. A classification system for associated drugs was developed a priori based upon the number of cases, re-challenge, exclusion of non-drug causes of acute pancreatitis, and consistency of latency. RESULTS: Seven-hundred and thirteen cases of potential drug-induced pancreatitis were identified, implicating 213 unique drugs. The evidence base was poor: exclusion of non-drug causes of acute pancreatitis was incomplete or poorly reported in all cases, 47% had at least one underlying condition predisposing to acute pancreatitis, and causality assessment was not conducted in 81%. Forty-five drugs (21%) were classified as having the highest level of evidence regarding their association with acute pancreatitis; causality was deemed to be probable or definite for 19 of these drugs (42%). Fifty-seven drugs (27%) had the lowest level of evidence regarding an association with acute pancreatitis, being implicated in single case reports, without exclusion of other causes of acute pancreatitis. DISCUSSION: Much of the case report evidence upon which drug-induced pancreatitis associations are based is tenuous. A greater emphasis on exclusion of all non-drug causes of acute pancreatitis and on quality reporting would improve the evidence base. It should be recognized that reviews of case reports, are valuable scoping tools but have limited strength to establish drug-induced pancreatitis associations. REGISTRATION: CRD42017060473.
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spelling pubmed-71646262020-04-22 Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations Wolfe, Dianna Kanji, Salmaan Yazdi, Fatemeh Barbeau, Pauline Rice, Danielle Beck, Andrew Butler, Claire Esmaeilisaraji, Leila Skidmore, Becky Moher, David Hutton, Brian PLoS One Research Article OBJECTIVE: A current assessment of case reports of possible drug-induced pancreatitis is needed. We systematically reviewed the case report literature to identify drugs with potential associations with acute pancreatitis and the burden of evidence supporting these associations. METHODS: A protocol was developed a priori (PROSPERO CRD42017060473). We searched MEDLINE, Embase, the Cochrane Library, and additional sources to identify cases of drug-induced pancreatitis that met accepted diagnostic criteria of acute pancreatitis. Cases caused by multiple drugs or combination therapy were excluded. Established systematic review methods were used for screening and data extraction. A classification system for associated drugs was developed a priori based upon the number of cases, re-challenge, exclusion of non-drug causes of acute pancreatitis, and consistency of latency. RESULTS: Seven-hundred and thirteen cases of potential drug-induced pancreatitis were identified, implicating 213 unique drugs. The evidence base was poor: exclusion of non-drug causes of acute pancreatitis was incomplete or poorly reported in all cases, 47% had at least one underlying condition predisposing to acute pancreatitis, and causality assessment was not conducted in 81%. Forty-five drugs (21%) were classified as having the highest level of evidence regarding their association with acute pancreatitis; causality was deemed to be probable or definite for 19 of these drugs (42%). Fifty-seven drugs (27%) had the lowest level of evidence regarding an association with acute pancreatitis, being implicated in single case reports, without exclusion of other causes of acute pancreatitis. DISCUSSION: Much of the case report evidence upon which drug-induced pancreatitis associations are based is tenuous. A greater emphasis on exclusion of all non-drug causes of acute pancreatitis and on quality reporting would improve the evidence base. It should be recognized that reviews of case reports, are valuable scoping tools but have limited strength to establish drug-induced pancreatitis associations. REGISTRATION: CRD42017060473. Public Library of Science 2020-04-17 /pmc/articles/PMC7164626/ /pubmed/32302358 http://dx.doi.org/10.1371/journal.pone.0231883 Text en © 2020 Wolfe et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Wolfe, Dianna
Kanji, Salmaan
Yazdi, Fatemeh
Barbeau, Pauline
Rice, Danielle
Beck, Andrew
Butler, Claire
Esmaeilisaraji, Leila
Skidmore, Becky
Moher, David
Hutton, Brian
Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations
title Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations
title_full Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations
title_fullStr Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations
title_full_unstemmed Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations
title_short Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations
title_sort drug induced pancreatitis: a systematic review of case reports to determine potential drug associations
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164626/
https://www.ncbi.nlm.nih.gov/pubmed/32302358
http://dx.doi.org/10.1371/journal.pone.0231883
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