Title: Gall stone Disease after starting Liraglutide, Is it reversible?
Authors: Dr Jayesh Kalbhande, Dr Mayank Chaudhary
DOI: https://dx.doi.org/10.18535/jmscr/v11i6.06
Abstract
Objective: Liraglutide is known to cause gall stones and its related complication. They are often subjected to cholecystectomy. We describe a case of Liraglutide induced cholelithiasis and cholecystitis which was managed conservatively. The gall stones resolved after stopping Liraglutide. This is only second such case report of complete resolution of gall stones after discontinuation of Liraglutide.
Case Description: A 66 years old female patient, Diabetic and Hypertensive, who was on Inj. Liraglutide for her diabetes presented with complaints of fever, right side hypochondriac pain and few episodes of vomiting. Upon clinical examination, patient was vitally stable and necessary blood investigations were done. Her CT scan of abdomen and pelvis showed layered grain size hyperdense opacities in Gall bladder lumen. She was put on I.V. antibiotics and nil per orally. Her Inj. Liraglutide was discontinued and started on Basal Glargine insulin with intermittent Human Regular insulin for control of blood sugars and continued monitoring was done. She showed significant improvement showing no pain and tenderness in right hypochondriac region and her blood and serum reports showed considerable improvement. She remained asymptomatic and subsequent USG reports showed normal gall bladder with no evidence of calculus or sludge seen.
Conclusion: Gall stones associated with Liraglutide treatment is a reversible disease after stopping treatment of Liraglutide. The use of GLP-1 analogues was associated with an increased risk of bile duct and gallbladder disease. Physicians should be aware of this potential adverse event when prescribing these drugs.
References
- Wettergren A, Schjoldager B, Mortensen PE, Myhre J, Christiansen J, Holst JJ. Truncated GLP-1 (proglucagon 78–107-amide) inhibits gastric and pancreatic functions in man. Digestive diseases and sciences. 1993 Apr;38(4):665-73.
- Korkmaz H, Araz M, Alkan S, Akarsu E. Liraglutide-related cholelithiasis. Aging clinical and experimental research. 2015 Oct;27:751-3.
- Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DC, Le Roux CW, Violante Ortiz R, Jensen CB, Wilding JP. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. New England Journal of Medicine. 2015 Jul 2;373(1):11-22.
- Faillie JL, Oriana HY, Yin H, Hillaire-Buys D, Barkun A, Azoulay L. Association of bile duct and gallbladder diseases with the use of incretin-based drugs in patients with type 2 diabetes mellitus. JAMA internal medicine. 2016 Oct 1;176(10):1474-81.
- Nexøe‐Larsen CC, Sørensen PH, Hausner H, Agersnap M, Baekdal M, Brønden A, Gustafsson LN, Sonne DP, Vedtofte L, Vilsbøll T, Knop FK. Effects of liraglutide on gallbladder emptying: A randomized, placebo‐controlled trial in adults with overweight or obesity. Diabetes, Obesity and Metabolism. 2018 Nov;20(11):2557-64.
- Nauck MA, MuusGhorbani ML, Kreiner E, Saevereid HA, Buse JB, LEADER Publication Committee on behalf of the LEADER Trial Investigators. Effects of liraglutide compared with placebo on events of acute gallbladder or biliary disease in patients with type 2 diabetes at high risk for cardiovascular events in the LEADER randomized trial. Diabetes care. 2019 Oct 1;42(10):1912-20.
- Nreu B, Dicembrini I, Tinti F, Mannucci E, Monami M. Cholelithiasis in patients treated with glucagon-like peptide-1 receptor: an updated meta-analysis of randomized controlled trials. Diabetes research and clinical practice. 2020 Mar 1;161:108087.