title: Acute pancreatitis associated with liraglutide.
abstract: OBJECTIVE
  To report what is, to our knowledge, the first postmarketing case of acute pancreatitis associated with liraglutide.
  
  
  METHODS
  A 60-year-old female with type 2 diabetes presented with a 16-hour history of mid-epigastric pain 3 weeks after treatment was changed from exenatide 10 μg twice daily, which she had taken for 4 years, to liraglutide 1.8 mg daily. Her serum lipase level was elevated (478 units/L) at admission, and other laboratory values were within normal limits. Liraglutide was discontinued at admission. Standard therapy for pancreatitis resulted in symptom resolution and a significant decrease in serum lipase (131 units/L) by hospital day 4; she was discharged on hospital day 5.
  
  
  CONCLUSIONS
  Based on the Naranjo scale, this case represents a probable adverse drug reaction. Eight cases of pancreatitis were observed in liraglutide-treated patients in premarketing clinical trials. Extensive literature describing exenatide-related pancreatitis and premarketing reports of liraglutide-related pancreatitis, along with the temporal relationship between the initiation of liraglutide and the onset of this patient's symptoms, suggest that the episode of pancreatitis was induced by liraglutide.
  
  
  CONCLUSIONS
  Liraglutide should be used cautiously in patients with a history of pancreatitis, and clinicians should have a high index of suspicion for this rare, but potentially serious, adverse effect.
authors.affiliation: College of Pharmacy, University of Tennessee Medical Center, Knoxville, TN, USA.
authors.forename: Phillip H
authors.initials: PH
authors.lastname: Lee
authors.forename: M David
authors.initials: MD
authors.lastname: Stockton
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Franks
mesh_terms: D000208:Acute Disease; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000201:enzymology; D000077270:Exenatide; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008049:Lipase / Q000097:blood; D000069450:Liraglutide; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced*; D010455:Peptides / Q000627:therapeutic use; D014688:Venoms / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D010455:Peptides; D014688:Venoms; D000069450:Liraglutide; D052216:Glucagon-Like Peptide 1; D000077270:Exenatide; D008049:Lipase