Sitagliptin-associated Acute Pancreatitis: A Case Report

在台灣最新被核淮用於治療第二型糖尿病的口服藥是第四型雙胜肽蛋白水解酶的抑制劑(dipeptidyl peptidase-4 inhibitors)，它常見的副作用是腸胃道方面的症狀及低血糖。然而上市後的追蹤卻發現似乎和急性胰臟炎的發生有所關聯•在這個個案中，我們的病人在使用sitagliptin後約50天產生了急性胰臟炎；回顧她的病史，過去從沒有急性胰臟炎，同時並沒有急性胰臟炎常見的危險因子，包括很高的高三酸甘油脂血症，膽結石及酒精濫用等，同時其發生的時間與國外的報導相似•腸促胰泌素(incretin)類的藥物是最新一類被核淮用於治療第二型糖尿病的藥物，它主要是增加血中類昇糖激素胜肽(Glucagon-like peptide-1, GLP-1)而達到降血糖的目的，然而上市之後陸續發現不論是注射的類昇糖激素胜肽類似物或第四型雙胜肽蛋白水解酶的抑制劑都有文獻報導似乎和急性胰臟炎有相關。雖然有些研究認爲急性胰臟炎的發生可能和糖尿病本身有關而不是這類藥物，但此個案報告仍希望能讓臨床醫師在使用這類藥物時多注意是否有急性胰臟炎的發生。

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並列摘要

The most recently-approved class of agents to treat type 2 diabetes in Taiwan is dipeptidyl peptidase-4 (DPP-4) inhibitors, most popularly sitagliptin. Commonly reported adverse events with sitagliptin include upper respiratory tract infections, sore throat, headache and diarrhea. Post-marketing surveillance has raised the possibility of acute pancreatitis in association with its use. Here we presented a case of type 2 diabetes with acute pancreatitis after 50 days' use of sitagliptin, which is similar to previous report in time of onset of acute pancreatitis after use of sitagliptin. She has no past history of acute pancreatitis, nor any common inciting factors of acute pancreatitis, including hypertriglyceridemia, gallstones and alcohol abuse. Incretin-based therapy, including the glucagon-like peptide-1 (GLP-1) receptor agonists and DPP-4 inhibitors, lowers serum glucose by increasing serum GLP-1 level. Post-marketing surveillance suggests an association between incretin-based therapy and acute pancreatitis. However, some analysis suggested that acute pancreatitis may be associated with diabetes per se. Although the causal relationship of incretin-based therapy and acute pancreatitis is still not clear, we still should be alert to its possible side effects.

並列關鍵字

Sitagliptin ； Acute pancreatitis ； GLP-1 agonist ； Type 2 diabetes

國際替代計量

Sitagliptin-associated Acute Pancreatitis: A Case Report

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