Exenatide-Induced Eosinophilic Sclerosing Lipogranuloma at the Injection Site

Shan, Shijun; Guo, Ying

doi:10.1097/dad.0000000000000036

Cited by 28 publications

(18 citation statements)

References 7 publications

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“…Because adverse effects were not associated with exenatide ER in the present study and none was moderate to severe or long‐lasting, we believe the GLP‐1 analogue can be safely used in diabetic cats. Of note, injection site irritation as well as nodular, eosinophil‐rich, granulomatous panniculitis at the injection site of exenatide has been described in humans . To date, dermatologic irritation has not been reported in cats .…”

Section: Discussionmentioning

confidence: 99%

Effect of the Glucagon‐like Peptide‐1 Analogue Exenatide Extended Release in Cats with Newly Diagnosed Diabetes Mellitus

Riederer

Zini

Salesov

et al. 2015

Veterinary Internal Medicne

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BackgroundExenatide extended release (ER) is a glucagon‐like peptide‐1 analogue that increases insulin secretion, inhibits glucagon secretion and induces satiation in humans with type 2 diabetes mellitus. The use of exenatide ER is safe and stimulates insulin secretion in healthy cats.ObjectivesThe objective of this study is to assess the safety of exenatide ER and its effect on body weight, remission and metabolic control in newly diagnosed diabetic cats receiving insulin and a low‐carbohydrate diet.AnimalsThirty client‐owned cats.MethodsProspective placebo‐controlled clinical trial. Cats were treated with exenatide ER or 0.9% saline, administered SC, once weekly. Both groups received insulin glargine and a low‐carbohydrate diet. Exenatide ER was administered for 16 weeks, or in cats that achieved remission it was given for 4 weeks after discontinuing insulin treatment. Nonparametric tests were used for statistical analysis.ResultsCats in the exenatide ER and placebo groups had transient adverse signs including decreased appetite (60% vs. 20%, respectively, P = .06) and vomiting (53% vs. 40%, respectively, P = .715). Body weight increased significantly in the placebo group (P = .002), but not in cats receiving exenatide ER. Cats on exenatide ER achieved remission or good metabolic control in 40% or 89%, respectively, whereas in control cats percentages were 20% or 58% (P = .427 and P = .178, respectively).Conclusion and clinical importanceExenatide ER is safe in diabetic cats and does not result in weight gain. Our pilot study suggests that, should there be an additional clinically relevant beneficial effect of exenatide ER in insulin‐treated cats on rate of remission and good metabolic control, it would likely approximate 20% and 30%, respectively.

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Section: Discussionmentioning

confidence: 99%

Effect of the Glucagon‐like Peptide‐1 Analogue Exenatide Extended Release in Cats with Newly Diagnosed Diabetes Mellitus

Riederer

Zini

Salesov

et al. 2015

Veterinary Internal Medicne

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“…In some case reports, exenatide administration has been associated with the development of panniculitis, although a causal association has not been proven [112][113][114]. Hyperhidrosis was reported as a common adverse event (≥1/100 to < 1/10), while alopecia and macular/papular rash were found to be rare (≥1/10,000 to < 1/1,000), in phase III trials of exenatide [48].…”

Section: Skin Side Effectsmentioning

confidence: 99%

Adverse Effects of GLP-1 Receptor Agonists

2014

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■ AbstractGlucagon-like peptide-1 (GLP-1) receptor agonists are a class of injective anti-diabetic drugs that improve glycemic control and many other atherosclerosis-related parameters in patients with type 2 diabetes (T2D). However, the use of this relatively new class of drugs may be associated with certain adverse effects. Concerns have been expressed regarding the effects of these drugs on pancreatic and thyroid tissue, since animal studies and analyses of drug databases indicate an association of GLP-1 receptor agonists with pancreatitis, pancreatic cancer, and thyroid cancer. However, several meta-analyses failed to confirm a cause-effect relation between GLP-1 receptor agonists and the development of these adverse effects. One benefit of GLP-1 receptor agonists is that they do not cause hypoglycemia when combined with metformin or thiazolidinediones, but the dose of concomitant sulphonylurea or insulin may have to be decreased to reduce the risk of hypoglycemic episodes. On the other hand, several case reports have linked the use of these drugs, mainly exenatide, with the occurrence of acute kidney injury, primarily through hemodynamic derangement due to nausea, vomiting, and diarrhea. The most common symptoms associated with the use of GLP-1 receptor agonists are gastrointestinal symptoms, mainly nausea. Other common adverse effects include injection site reactions, headache, and nasopharyngitis, but these effects do not usually result in discontinuation of the drug. Current evidence shows that GLP-1 receptor agonists have no negative effects on the cardiovascular risk of patients with T2D. Thus, GLP-1 receptor agonists appear to have a favorable safety profile, but ongoing trials will further assess their cardiovascular effects. The aim of this review is to analyze critically the available data regarding adverse events of GLP-1 receptor agonists in different anatomic systems published in Pubmed and Scopus. Whenever possible, certain differences between GLP-1 receptor agonists are described. The review also provides the reader with structured data that compare the rates of the most common adverse effects for each of the various GLP-1 receptor agonists.

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“…Paraffinoma typically occurs in areas where lipid material has entered traumatically or has been injected for a specific purpose. The injected exogenous oils include paraffin, mineral oil, silicone, vaseline, vitamin E, and autologous fat9. Paraffinoma occurring after use of paraffin-containing materials, such as antibiotic ointment, has been reported.…”

Section: Discussionmentioning

confidence: 99%

“…This type of paraffinoma can be explained by the natural host response to wall off exogenous substances that are too large to be ingested by macrophages7. However, another type of paraffinoma that occurs after exenatide injection, triamcinolone injection, aluminum hydroxide injection, and trauma has been reported; however, this type cannot be explained by the above mechanism8910. Its mechanism involves endogenous fat degeneration8.…”

Section: Discussionmentioning

confidence: 99%

Late-Onset Complication of Fillers: Paraffinoma of the Lower Eyelids Clinically Mimicking Xanthelasma

et al. 2016

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Injectable poly-L-lactic acid (PLLA) is world-famous filler used in lipoatrophy and facial rejuvenation because of its collagen neogenesis effect which leads to gradual volume restoration. Until recently, quite a number of unwanted adverse events of PLLA have been reported. However, to the best of our knowledge, paraffinoma as a complication of PLLA has never been reported. We herein describe the first case of paraffinoma after Sculptra® injection and propose its possible mechanism.

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Exenatide-Induced Eosinophilic Sclerosing Lipogranuloma at the Injection Site

Cited by 28 publications

References 7 publications

Effect of the Glucagon‐like Peptide‐1 Analogue Exenatide Extended Release in Cats with Newly Diagnosed Diabetes Mellitus

Effect of the Glucagon‐like Peptide‐1 Analogue Exenatide Extended Release in Cats with Newly Diagnosed Diabetes Mellitus

Adverse Effects of GLP-1 Receptor Agonists

Late-Onset Complication of Fillers: Paraffinoma of the Lower Eyelids Clinically Mimicking Xanthelasma

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