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Simvastatin is associated with reduced risk of acute pancreatitis: findings from a regional integrated healthcare system

Objective To characterise the relationship between simvastatin and risk of acute pancreatitis (AP). Design We conducted a retrospective cohort study (2006–2012) on data from an integrated healthcare system in southern California. Exposure to simvastatin was calculated from time of initial dispensati... Full description

Journal Title: Gut 2015-01, Vol.64 (1), p.133-138
Main Author: Wu, Bechien U
Other Authors: Pandol, Stephen J , Liu, In-Lu Amy
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: England: BMJ Publishing Group Ltd
ID: ISSN: 0017-5749
Link: https://www.ncbi.nlm.nih.gov/pubmed/24742713
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title: Simvastatin is associated with reduced risk of acute pancreatitis: findings from a regional integrated healthcare system
format: Article
creator:
  • Wu, Bechien U
  • Pandol, Stephen J
  • Liu, In-Lu Amy
subjects:
  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Article
  • Care and treatment
  • Cohort Studies
  • Delivery of Health Care, Integrated
  • Dosage and administration
  • Female
  • Hospitals
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects
  • Male
  • Middle Aged
  • Pancreatitis
  • Pancreatitis - chemically induced
  • Pancreatitis - epidemiology
  • Pharmacy
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity analysis
  • Simvastatin
  • Simvastatin - adverse effects
  • Statins
  • Studies
  • Young Adult
ispartof: Gut, 2015-01, Vol.64 (1), p.133-138
description: Objective To characterise the relationship between simvastatin and risk of acute pancreatitis (AP). Design We conducted a retrospective cohort study (2006–2012) on data from an integrated healthcare system in southern California. Exposure to simvastatin was calculated from time of initial dispensation until 60 days following prescription termination. AP cases were defined by ICD-9 CM 577.0 and serum lipase≥3 times normal. Patients were censored at death, last follow-up, and onset of AP or end-of-study. Incidence rate of pancreatitis among simvastatin users was compared with the adult reference population. Robust Poisson regression was used to generate risk ratio (RR) estimates for simvastatin use adjusted for age, gender, race/ethnicity, gallstone-related disorders, hypertriglyceridaemia, smoking and alcohol dependence. Analysis was repeated for atorvastatin. Results Among 3 967 859 adult patients (median duration of follow-up of 3.4 years), 6399 developed an initial episode of AP. A total of 707 236 patients received simvastatin during the study period. Patients that received simvastatin were more likely to have gallstone-related disorders, alcohol dependence or hypertriglyceridaemia compared with the reference population. Nevertheless, risk of AP was significantly reduced with simvastatin use, crude incidence rate ratio 0.626 (95% CL 0.588, 0.668), p
language: eng
source:
identifier: ISSN: 0017-5749
fulltext: no_fulltext
issn:
  • 0017-5749
  • 1468-3288
url: Link


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titleSimvastatin is associated with reduced risk of acute pancreatitis: findings from a regional integrated healthcare system
creatorWu, Bechien U ; Pandol, Stephen J ; Liu, In-Lu Amy
creatorcontribWu, Bechien U ; Pandol, Stephen J ; Liu, In-Lu Amy
descriptionObjective To characterise the relationship between simvastatin and risk of acute pancreatitis (AP). Design We conducted a retrospective cohort study (2006–2012) on data from an integrated healthcare system in southern California. Exposure to simvastatin was calculated from time of initial dispensation until 60 days following prescription termination. AP cases were defined by ICD-9 CM 577.0 and serum lipase≥3 times normal. Patients were censored at death, last follow-up, and onset of AP or end-of-study. Incidence rate of pancreatitis among simvastatin users was compared with the adult reference population. Robust Poisson regression was used to generate risk ratio (RR) estimates for simvastatin use adjusted for age, gender, race/ethnicity, gallstone-related disorders, hypertriglyceridaemia, smoking and alcohol dependence. Analysis was repeated for atorvastatin. Results Among 3 967 859 adult patients (median duration of follow-up of 3.4 years), 6399 developed an initial episode of AP. A total of 707 236 patients received simvastatin during the study period. Patients that received simvastatin were more likely to have gallstone-related disorders, alcohol dependence or hypertriglyceridaemia compared with the reference population. Nevertheless, risk of AP was significantly reduced with simvastatin use, crude incidence rate ratio 0.626 (95% CL 0.588, 0.668), p<0.0001. In multivariate analysis, simvastatin was independently associated with reduced risk of pancreatitis, adjusted RR 0.29 (95% CL 0.27, 0.31) after adjusting for age, gender, race/ethnicity, gallstone disorders, alcohol dependence, smoking and hypertriglyceridaemia. Similar results were noted with atorvastatin, adjusted RR 0.33(0.29, 0.38). Conclusions Use of simvastatin was independently associated with reduced risk of AP in this integrated healthcare setting. Similar findings for atorvastatin suggest a possible class effect.
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subjectAcute Disease ; Adolescent ; Adult ; Aged ; Article ; Care and treatment ; Cohort Studies ; Delivery of Health Care, Integrated ; Dosage and administration ; Female ; Hospitals ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects ; Male ; Middle Aged ; Pancreatitis ; Pancreatitis - chemically induced ; Pancreatitis - epidemiology ; Pharmacy ; Retrospective Studies ; Risk Assessment ; Sensitivity analysis ; Simvastatin ; Simvastatin - adverse effects ; Statins ; Studies ; Young Adult
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descriptionObjective To characterise the relationship between simvastatin and risk of acute pancreatitis (AP). Design We conducted a retrospective cohort study (2006–2012) on data from an integrated healthcare system in southern California. Exposure to simvastatin was calculated from time of initial dispensation until 60 days following prescription termination. AP cases were defined by ICD-9 CM 577.0 and serum lipase≥3 times normal. Patients were censored at death, last follow-up, and onset of AP or end-of-study. Incidence rate of pancreatitis among simvastatin users was compared with the adult reference population. Robust Poisson regression was used to generate risk ratio (RR) estimates for simvastatin use adjusted for age, gender, race/ethnicity, gallstone-related disorders, hypertriglyceridaemia, smoking and alcohol dependence. Analysis was repeated for atorvastatin. Results Among 3 967 859 adult patients (median duration of follow-up of 3.4 years), 6399 developed an initial episode of AP. A total of 707 236 patients received simvastatin during the study period. Patients that received simvastatin were more likely to have gallstone-related disorders, alcohol dependence or hypertriglyceridaemia compared with the reference population. Nevertheless, risk of AP was significantly reduced with simvastatin use, crude incidence rate ratio 0.626 (95% CL 0.588, 0.668), p<0.0001. In multivariate analysis, simvastatin was independently associated with reduced risk of pancreatitis, adjusted RR 0.29 (95% CL 0.27, 0.31) after adjusting for age, gender, race/ethnicity, gallstone disorders, alcohol dependence, smoking and hypertriglyceridaemia. Similar results were noted with atorvastatin, adjusted RR 0.33(0.29, 0.38). Conclusions Use of simvastatin was independently associated with reduced risk of AP in this integrated healthcare setting. Similar findings for atorvastatin suggest a possible class effect.
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abstractObjective To characterise the relationship between simvastatin and risk of acute pancreatitis (AP). Design We conducted a retrospective cohort study (2006–2012) on data from an integrated healthcare system in southern California. Exposure to simvastatin was calculated from time of initial dispensation until 60 days following prescription termination. AP cases were defined by ICD-9 CM 577.0 and serum lipase≥3 times normal. Patients were censored at death, last follow-up, and onset of AP or end-of-study. Incidence rate of pancreatitis among simvastatin users was compared with the adult reference population. Robust Poisson regression was used to generate risk ratio (RR) estimates for simvastatin use adjusted for age, gender, race/ethnicity, gallstone-related disorders, hypertriglyceridaemia, smoking and alcohol dependence. Analysis was repeated for atorvastatin. Results Among 3 967 859 adult patients (median duration of follow-up of 3.4 years), 6399 developed an initial episode of AP. A total of 707 236 patients received simvastatin during the study period. Patients that received simvastatin were more likely to have gallstone-related disorders, alcohol dependence or hypertriglyceridaemia compared with the reference population. Nevertheless, risk of AP was significantly reduced with simvastatin use, crude incidence rate ratio 0.626 (95% CL 0.588, 0.668), p<0.0001. In multivariate analysis, simvastatin was independently associated with reduced risk of pancreatitis, adjusted RR 0.29 (95% CL 0.27, 0.31) after adjusting for age, gender, race/ethnicity, gallstone disorders, alcohol dependence, smoking and hypertriglyceridaemia. Similar results were noted with atorvastatin, adjusted RR 0.33(0.29, 0.38). Conclusions Use of simvastatin was independently associated with reduced risk of AP in this integrated healthcare setting. Similar findings for atorvastatin suggest a possible class effect.
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pmid24742713
doi10.1136/gutjnl-2013-306564
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