Though the causes of acute pancreatitis are unknown in roughly a quarter of its worldwide patient population, a recent analysis published in JAMA Internal Medicine
has discovered a link between increased risk of the disease and medicines containing cortisone.
In their population-based “Association of Oral Glucocorticoid Use With an Increased Risk of Acute Pancreatitis” study, Omid Sadr-Azodi, MD, PhD, an assistant physician in the surgery and urology unit at Eskilstuna County Hospital, in Sweden, and researchers at the Karolinska Institutet compared 6,161 patients between the ages of 40 and 84 who were diagnosed with a first episode of acute pancreatitis between 2006 and 2008 with 61,637 healthy control subjects. At the conclusion of the case-control study, the researchers found patients treated with a tablet form of glucocorticoid were 70 percent more likely to develop a sudden inflammation of the pancreas between four and 14 days after drug dispensation than those who were not given the medical cortisone.
The researchers adjusted for common causes of acute pancreatitis — including alcohol abuse, diabetes and affiliated drug use — and they observed the connection between oral glucocorticoid use and acute pancreatitis risk just three days after dose administration, which substantiated the evidence pinpointing cortisone as the perpetrator.
“Drug-induced acute pancreatitis has previously been considered as a rare cause of acute pancreatitis, but recent reports have indicated that drug-induced acute pancreatitis might be the third most common cause of the disease, accounting for 3 to 5 percent of all cases,” the authors wrote. Though most patients recover from an episode of acute pancreatitis without complications, the authors added in a press release the disease develops into a life-threatening condition in 15 to 20 percent of patients.
While cortisone is occasionally used to treat patients with asthma and rheumatic diseases, Sadr-Azodi said in a press release the researchers did not see an increased risk of acute pancreatitis in patients who received aerosol cortisone, including asthma inhalers.
Previous studies examining individual cases indicated a causal relationship between acute pancreatitis and certain medications — some containing cortisone — but the Karolinska Institutet analysis was the first methodical study to demonstrate a link between the disease and cortisone tablets.