Statins chronic use is associated to decreased post-ERCP acute pancreatitis incidence

Moneo, Emma Martínez; Jaén, Karina Cárdenas; Laso, Ana Belén Fernández; Bocos, Judith Millastre; Gallego, Ainara Torralba; Arriero, Silvia Martín; Almajano, Enrique Alfaro; Rayado, G. García; de–Madaria, Enrique

doi:10.1016/j.pan.2017.05.244

Cited by 5 publications

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“…The literature has been less convincing regarding the risk of DIP from statins 42 . Several studies have shown that statins may be useful as preventative agents for pancreatitis, 30 including postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) 43,44 . One study found that patients taking statins had lower amylase levels and less overall incidence of both pancreatitis and PEP than non-statin users 42 .…”

Section: Discussionmentioning

confidence: 99%

“…42 Several studies have shown that statins may be useful as preventative agents for pancreatitis, 30 including postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). 43,44 One study found that patients taking statins had lower amylase levels and less overall incidence of both pancreatitis and PEP than non-statin users. 42 Similarly, another retrospective study of 1162 ERCPs found that statin users had an PEP incidence of 3.4% compared to 9.5% in non-statin users.…”

Section: Statinsmentioning

confidence: 99%

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Quantifying the Risk of Drug-Induced Pancreatitis With Angiotensin-Converting Enzyme Inhibitors and Statins Using a Large Electronic Medical Record Database

et al. 2021

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Objectives: Quantify the risk of drug-induced pancreatitis (DIP) from angiotensin-converting enzyme inhibitors (ACEis) and 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors (statins).Methods: Retrospective cohort analysis using IBM Explorys (1999-2019), a pooled, deidentified clinical database of more than 63 million patients across the United States. Odds ratios were calculated to determine the risk of DIP from ACEi, statins, and both medications together. χ 2 testing assessed the relationship between age, sex, ethnicity, insurance status, and mortality among patients with DIP from ACEi, statins, or both combined.Results: Acute pancreatitis (AP) was found in 280,740 patients. Odds ratios for ACEi, statins, and both combined were 6.12, 4.97, and 5.72, respectively. Thirty-eight percent of all-cause AP occurs in adults older than 65 years. Acute pancreatitis from ACEi and statins occurs in 49% and 56% of patients older than 65 years, respectively. Men and patients older than 65 years are at higher risk of DIP from ACEi and statins. Patients on Medicaid are at higher risk of DIP from statins, and Asian patients are at highest risk of DIP from ACEi. Conclusions:We found that ACEi and statins increase the odds of DIP.Although ACEis and statins are critical medications for many patients, clinicians should consider using alternatives in patients with AP of unclear etiology.

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Section: Discussionmentioning

confidence: 99%

Section: Statinsmentioning

confidence: 99%

Quantifying the Risk of Drug-Induced Pancreatitis With Angiotensin-Converting Enzyme Inhibitors and Statins Using a Large Electronic Medical Record Database

et al. 2021

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“…The total sample size will include about 1016 patients, which was based on assuming a 5% incidence of PEP among NSt users, a 1-3 ratio of St and NSt consumers respectively, and a 70% decrease of PEP rate among St consumers [1,8,16]. Alpha-error was set 0.05 and beta-error 0.20.…”

Section: Methodsmentioning

confidence: 99%

Chronic use of statins and risk of post-ERCP acute pancreatitis (STARK): Study protocol for an international multicenter prospective cohort study

Korpela

Cárdenas-Jaén

Poropat

et al. 2018

Digestive and Liver Disease

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Reduced risk of post ERCP pancreatitis in statin users

et al. 2020

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Background: One of the most feared complications of endoscopic retrograde cholangiopancreatography (ERCP), with an incidence of 3.5 to 15%, is post ERCP pancreatitis (PEP). Given the role of statins in the reduction of systemic and pancreatic intraluminal inflammation, we hypothesized that the use of statins may lower the risk of PEP. Methods: A retrospective cohort study of all patients undergoing ERCP at West Virginia University during the years 2016 and 2017 was performed. Possible association of collected variables with PEP was assessed with Univariate tests and multivariable logistic regression analyses. Results: A total of 1162 ERCPs were included. Mean age was 60.12 years (SD: 17.5). 51.3% of the participants were female. Two hundred and sixty-three participants underwent more than one ERCP during the study period. Seven hundred and ninety-nine ERCPs (78.8%) were conducted in participants who were not taking a statin medication at the time of ERCP, while 363 participants were on statin medications at the time of ERCP; 118 and 245 participants were taking high dose statins (atorvastatin 40-80 mg or rosuvastatin 20 mg), and low/medium dose statins (all other statin regimens) at the time of the procedure, respectively. The overall incidence of PEP in the cohort was 7.3%. In the non-statin and statin groups, 9.5 and 3.4% of participants developed PEP, respectively. On univariate analysis, young age, no statin use, history of PEP, and endoscopic sphincterotomy were found to be significantly associated with the development of PEP. In a binary logistic regression model, young age (P = 0.033), history of PEP (P = 0.0001, OR 2.41, 95% CI: 1.05-5.51) and endoscopic sphincterotomy (P = 0.038, OR 2.85, 95% CI: 1.7-4.78) were found to be associated with increased risk of PEP. Statin usage was found to be protective against PEP, (OR 0.35, 95% CI: 0.18-0.69). Conclusion: Chronic statin usage is protective against post ERCP pancreatitis, and our findings suggest a potential role of these drugs as prophylactic agents. Randomized controlled trials are needed to establish any potential clinical application.

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Statins chronic use is associated to decreased post-ERCP acute pancreatitis incidence

Cited by 5 publications

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Quantifying the Risk of Drug-Induced Pancreatitis With Angiotensin-Converting Enzyme Inhibitors and Statins Using a Large Electronic Medical Record Database

Quantifying the Risk of Drug-Induced Pancreatitis With Angiotensin-Converting Enzyme Inhibitors and Statins Using a Large Electronic Medical Record Database

Chronic use of statins and risk of post-ERCP acute pancreatitis (STARK): Study protocol for an international multicenter prospective cohort study

Reduced risk of post ERCP pancreatitis in statin users

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