Fateh Bazerbachi1, Samir Haffar2, Mohammad Tahir Hussain3, Eric J Vargas4, Kymberly D Watt5, M Hassan Murad6, Suresh Chari7, Barham K Abu Dayyeh8. 1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: Bazerbachi.Fateh@mayo.edu. 2. Digestive Center for Diagnosis and Treatment, 29 Ayar Street, Damascus, Syrian Arab Republic. Electronic address: shaffar75@gmail.com. 3. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: Hussain.mohammad@mayo.edu. 4. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: VargasValls.Eric@mayo.edu. 5. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: Watt.Kymberly@mayo.edu. 6. Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States. Electronic address: murad.mohammad@mayo.edu. 7. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: Chari.Suresh@mayo.edu. 8. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: Abudayyeh.barham@mayo.edu.
Abstract
BACKGROUND: Acute pancreatitis (AP) associated with interferon-α or pegylated interferon-α (AP-IFN) has been described, although the causal relation certitude remains elusive. Some recent studies suggest definite causality, although the relation is grouped in class III of Badalov classification of drug-induced AP. OBJECTIVES: Perform systematic review of AP-IFN and assess causality. METHODS: Two reviewers independently evaluated the data and quality of studies extracted from multiple databases on March 13, 2017. Studies selection was based on a priori criteria. Naranjo scale, and Badalov classification were applied to determine causality. RESULTS: We identified 16 studies that reported AP-IFN with a total of 23 patients. Fifteen studies had moderate to good methodological quality. The frequency of AP-IFN was 7/3450 (0.2%). The median age of patients was 50 years. In most cases IFN was used for chronic hepatitis C. The latency between IFN and diagnosis of AP was (>30 days). AP was mild or moderately severe and improved with supportive management. No mortality was observed. Re-challenge was done in 5 patients and resulted in AP recurrence in 3 cases. Twenty-one cases were classified as probable and 2 cases as definitive according to Naranjo scale. Evaluations of studies confirm a status Ia for AP-IFN according to Badalov classification. CONCLUSION: AP-IFN is rare and has a probable or definite causal relation according to Naranjo scale. The evidence supports a class Ia of Badalov classification. Hypertriglyceridemia is not a contributing factor. IFN-induced AP is usually mild or moderately severe, and responds favorably to supportive management.
BACKGROUND: Acute pancreatitis (AP) associated with interferon-α or pegylated interferon-α (AP-IFN) has been described, although the causal relation certitude remains elusive. Some recent studies suggest definite causality, although the relation is grouped in class III of Badalov classification of drug-induced AP. OBJECTIVES: Perform systematic review of AP-IFN and assess causality. METHODS: Two reviewers independently evaluated the data and quality of studies extracted from multiple databases on March 13, 2017. Studies selection was based on a priori criteria. Naranjo scale, and Badalov classification were applied to determine causality. RESULTS: We identified 16 studies that reported AP-IFN with a total of 23 patients. Fifteen studies had moderate to good methodological quality. The frequency of AP-IFN was 7/3450 (0.2%). The median age of patients was 50 years. In most cases IFN was used for chronic hepatitis C. The latency between IFN and diagnosis of AP was (>30 days). AP was mild or moderately severe and improved with supportive management. No mortality was observed. Re-challenge was done in 5 patients and resulted in AP recurrence in 3 cases. Twenty-one cases were classified as probable and 2 cases as definitive according to Naranjo scale. Evaluations of studies confirm a status Ia for AP-IFN according to Badalov classification. CONCLUSION: AP-IFN is rare and has a probable or definite causal relation according to Naranjo scale. The evidence supports a class Ia of Badalov classification. Hypertriglyceridemia is not a contributing factor. IFN-induced AP is usually mild or moderately severe, and responds favorably to supportive management.
Authors: Ana Karla G Melo; Keilla M Milby; Ana Luiza M A Caparroz; Ana Carolina P N Pinto; Rodolfo R P Santos; Aline P Rocha; Gilda A Ferreira; Viviane A Souza; Lilian D A Valadares; Rejane M R A Vieira; Gecilmara S Pileggi; Virgínia F M Trevisani Journal: PLoS One Date: 2021-06-29 Impact factor: 3.240
Authors: Fateh Bazerbachi; Akira Dobashi; Swarup Kumar; Sanjay Misra; Navtej S Buttar; Louis M Wong Kee Song Journal: Gastroenterol Rep (Oxf) Date: 2020-12-03