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Drug-Induced Acute Pancreatitis: An Evidence-Based Classification (Revised)
Jasmine Saini1, Daniel Marino, Nison Badalov
1Maimonides Medical Center, State University of New York-Downstate Medical Center, Brooklyn, New York, USA.
Clinical and Translational Gastroenterology
|July 13, 2023
Summary
Many drugs are incorrectly linked to acute pancreatitis due to weak evidence. This revised classification system uses higher quality studies to accurately identify causative medications, improving diagnosis of drug-induced acute pancreatitis.
Area of Science:
- Gastroenterology
- Clinical Pharmacology
Background:
- Drug-induced acute pancreatitis diagnosis is challenging.
- Previous classification systems relied heavily on case reports, leading to misinterpretations.
- Higher evidentiary value studies are needed for accurate drug-induced acute pancreatitis identification.
Purpose of the Study:
- To propose a revised, evidence-based classification system for drug-induced acute pancreatitis.
- To improve the accuracy of identifying causative medications.
- To utilize the Grading of Recommendations, Development, and Evaluation (GRADE) criteria.
Main Methods:
- Literature search for medication-induced acute pancreatitis case reports.
- Categorization of implicated drugs into four groups based on evidence quality.
- Application of GRADE criteria for evidence assessment.
Main Results:
- 141 drugs were identified in the literature as potentially causing acute pancreatitis.
- 106 drugs were supported by high-quality case reports.
- Only 3 drugs had evidence from randomized controlled trials, including 6-mercaptopurine and azathioprine.
Conclusions:
- The majority of drugs linked to acute pancreatitis have low-quality evidence.
- A revised classification system using higher-level evidence is crucial.
- Accurate identification of causative drugs will improve patient diagnosis and management.
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