Canagliflozin-induced pancreatitis: a rare side effect of a new drug

Chowdhary, Mudit; Kabbani, Ahmad A; Chhabra, Akansha

doi:10.2147/tcrm.s86641

Cited by 32 publications

(21 citation statements)

References 18 publications

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“…Two case reports of acute pancreatitis associated with DKA in patients with temporal exposure to canagliflozin were published in 2015. (20, 21) The exact mechanism for the development of pancreatitis and whether there is a similar risk with other drugs in the SGLT2 inhibitor class remains unknown.…”

Section: Adverse Side Effects and Warningsmentioning

confidence: 99%

An update on sodium-glucose co-transporter-2 inhibitors for the treatment of diabetes mellitus

Hsia

Grove²,

Cefalu³

2017

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

391

262

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Purpose of review SGLT2 inhibitors are the newest class of oral anti-hyperglycemic agents that have been approved for the treatment of diabetes mellitus. Over the past year there have been significant developments in both the safety and efficacy of this class of medications that are presented in this review. Recent findings Besides data on the glucose lowering effect of SGLT2 inhibitors, other metabolic benefits have been demonstrated for this class of medications. Moreover, there have been 3 FDA Drug Safety Communications issued in 2015 that have led to additional drug labeling. The basic mechanism of action, indications, glucose-lowering benefits, other metabolic benefits, and adverse side effects of SGLT2 inhibitors are presented in this review. Summary SGLT2 inhibitors are medications that have a unique mechanism of action and that lower glucose independent of insulin. Given the recent findings on efficacy and benefits, these agents are rapidly establishing their role in the treatment of diabetes. Especially in patients with type 2 diabetes not willing or not ready to start insulin, SGLT2 inhibitors may be another option in those patients requiring additional glucose lowering and in those with acceptable risk factor profiles. Although there appears to be some positive benefits in cardiovascular endpoints, more research on the long term outcomes in people taking SGLT2 inhibitors is warranted.

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Section: Adverse Side Effects and Warningsmentioning

confidence: 99%

An update on sodium-glucose co-transporter-2 inhibitors for the treatment of diabetes mellitus

Hsia

Grove²,

Cefalu³

2017

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

391

262

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“… 6 7 The FDA is also investigating reports of acute pancreatitis associated with the use of SGLT2 inhibitors. 8 9 10 …”

Section: Introductionmentioning

confidence: 99%

Sodium glucose cotransporter 2 inhibitors and risk of serious adverse events: nationwide register based cohort study

Ueda

Svanström

Melbye

et al. 2018

BMJ

286

255

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ObjectiveTo assess the association between the use of sodium glucose cotransporter 2 (SGLT2) inhibitors and seven serious adverse events of current concern.DesignRegister based cohort study.SettingSweden and Denmark from July 2013 to December 2016.ParticipantsA propensity score matched cohort of 17 213 new users of SGLT2 inhibitors (dapagliflozin, 61%; empagliflozin, 38%; canagliflozin, 1%) and 17 213 new users of the active comparator, glucagon-like peptide 1 (GLP1) receptor agonists.Main outcome measuresThe primary outcomes were lower limb amputation, bone fracture, diabetic ketoacidosis, acute kidney injury, serious urinary tract infection, venous thromboembolism, and acute pancreatitis, as identified from hospital records. Hazard ratios and 95% confidence intervals were estimated by using Cox proportional hazards models.ResultsUse of SGLT2 inhibitors, as compared with GLP1 receptor agonists, was associated with an increased risk of lower limb amputation (incidence rate 2.7 v 1.1 events per 1000 person years, hazard ratio 2.32, 95% confidence interval 1.37 to 3.91) and diabetic ketoacidosis (1.3 v 0.6, 2.14, 1.01 to 4.52) but not with bone fracture (15.4 v 13.9, 1.11, 0.93 to 1.33), acute kidney injury (2.3 v 3.2, 0.69, 0.45 to 1.05), serious urinary tract infection (5.4 v 6.0, 0.89, 0.67 to 1.19), venous thromboembolism (4.2 v 4.1, 0.99, 0.71 to 1.38) or acute pancreatitis (1.3 v 1.2, 1.16, 0.64 to 2.12).ConclusionsIn this analysis of nationwide registers from two countries, use of SGLT2 inhibitors, as compared with GLP1 receptor agonists, was associated with an increased risk of lower limb amputation and diabetic ketoacidosis, but not with other serious adverse events of current concern.

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“…So far, only three case reports describe the occurrence of pancreatitis with the use of Canagliflozin (another SGLT2 inhibitor) and none have been reported with Dapagliflozin till date. 9,10,11 The underlying mechanism of pancreatitis is not clear. It is likely to be an idiosyncratic reaction similar to other cases of drug-induced pancreatitis.…”

Section: Discussionmentioning

confidence: 99%