利拉鲁肽致胰腺炎的文献病例分析

Literature case analysis of liraglutide-induced pancreatitis

目的分析利拉鲁肽致胰腺炎的临床特点,为临床合理用药提供参考。方法计算机检索中国知网、维普网、万方数据、PubMed、Web of Science和Medline数据库,收集利拉鲁肽致胰腺炎的个案报道,检索时限为从建库起至2022年12月31日,描述性分析患者人口学特征、用药情况、临床表现、干预与转归等。结果共纳入文献17篇,涉及17例患者,其中男性7例、女性10例,年龄为25~75岁;均有用药指征,包括2型糖尿病14例,肥胖或超重3例;其中单一用药5例,合并用药12例。17例患者胰腺炎的发生时间均为利拉鲁肽用药后1 d~11个月,大多出现在6个月以内(14例);主要临床表现包括腹痛、恶心和呕吐等。诊断为胰腺炎后,16例停用利拉鲁肽,其中1例未予其他干预,15例予以对症治疗,16例患者症状均缓解,但2例在利拉鲁肽停用数周后再次发生胰腺炎,且均为重度胰腺炎,1例患者再次应用利拉鲁肽后胰腺炎再次发生。关联性评价结果显示,1例为“肯定”,4例为“可能”,其余患者为“很可能”。结论利拉鲁肽致胰腺炎多发生在用药6个月内,多为轻度、中重度,但也可能出现严重甚至致命的病例。临床在应用利拉鲁肽时,应定期监测患者胰酶水平并密切观察其临床表现,若出现疑似利拉鲁肽诱发的胰腺炎,应尽早停药并给予对症治疗。

OBJECTIVE To analyze the clinical characteristics of liraglutide-induced pancreatitis,and to provide reference for clinical rational drug use.METHODS Retrieved from CNKI,VIP,Wanfang database,PubMed,Web of Science and Medline,case reports about liraglutide-induced pancreatitis were collected from the inception to December 31st,2022.Demographic characteristics,drug use,clinical manifestations,intervention and outcome were analyzed using descriptive statistical method.RESULTS A total of 17 pieces of literature were collected and 17 patients were involved,including 7 males and 10 females.The patients aged from 25 to 75 years.All 17 patients had drug indications,including 14 cases of type 2 diabetes mellitus,3 cases of obesity or overweight.Among 17 patients,liraglutide was used alone in 5 cases,and combined with other drugs in 12 cases.Time from liraglutide administration to pancreatitis occurrence ranged from 1 day to 11 months after medication in 17 patients,with 14 cases less than 6 months.The clinical manifestations mainly included abdominal pain,nausea and vomiting,etc.After the diagnosis of pancreatitis,liraglutide discontinuation occurred in 16 patients;1 case did not receive any other interventions and the other 15 cases were managed with symptomatic supportive treatment;the symptoms of all 16 patients resolved;however,2 patients suffered from second episode of severe pancreatitis several weeks after liraglutide discontinuation,pancreatitis recurred after liraglutide rechallenge in 1 case.The results of correlation evaluation showed that 1 case was“positive”,4 cases were“possible”,and the remaining patients were“very likely”.CONCLUSIONS Liraglutide-induced pancreatitis mainly occurred within 6 months after drug administration.The majority of liraglutide-induced pancreatitis cases are mild to moderate,but there are also severe and even fatal cases.It is advisable to periodically monitor the level of pancreatic enzymes and closely observe patients’clinical mani-festations.In case of suspected liraglutide-induced pancreatitis,drug withdrawal and symptomatic treatment should be taken immediately.