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, S. Martín; Almajano, Enrique Alfaro; Rayado, G. García; de-Madaria, Enriqué

doi:10.1016/j.pan.2017.08.033

Cited by 4 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some reports have suggested an association of statins and reduced PEP [20,21], however, they did not control for confounders including rectal NSAID use, PD cannulation, and PD stent placement, as well as known risk shown conflicting results as they did not find an association between statin usage and risk of PEP in their retrospective cohort [22]. In our study, after controlling for all possible confounders, a high protective effect of use of statins on development of PEP was observed.…”

Section: Discussioncontrasting

confidence: 76%

Reduced risk of post ERCP pancreatitis in statin users

et al. 2020

View full text Add to dashboard Cite

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.

show abstract

Section: Discussioncontrasting

confidence: 76%

Reduced risk of post ERCP pancreatitis in statin users

et al. 2020

View full text Add to dashboard Cite

show abstract

“…To the best of our knowledge, this is one the first studies to prove that chronic statin use reduces the risk of emergence of PEP. The only group to perform a similar investigation is of de Madaria et al (Martinez-Moneo et al, 2017 ). Authors recruited a sample of 708 patients (median age of 70 years, 53.5% men, 29.5% on statins), and computed an incidence of PEP of 1.9% and of 5.8% among the consumers and non-consumers of statins, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported statins as a cause of acute pancreatitis (Badalov et al, 2007 ), yet, many others have shown their efficacy in preventing it (de-Madaria, 2017 ). Interestingly, preliminary results show that chronic statin administration appears to have a protective effect on the development of PEP (Martinez-Moneo et al, 2017 ), yet there are very few studies to assess such findings. The aim of our study was thus, to fill this gap in knowledge.…”

Section: Introductionmentioning

confidence: 99%

Chronic Use of Statins and Their Effect on Prevention of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

et al. 2018

View full text Add to dashboard Cite

Background and Aims: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is one of the major complications of ERCP. Thus, several non-invasive as well as invasive strategies have been investigated as preventative therapies for PEP with various efficacy.Methods: We enrolled any patients who underwent ERCP both at the Shaare Zedek Medical Center in Jerusalem and EMMS Nazareth hospital. Association between use of statins and different variables were assessed with univariate tests (chi-squared for categorical variables). Predictors of incidence of PEP and severity of pancreatitis were computed using conditional logistic regression, correcting for potential confounding factors.Results: 958 subjects were analyzed. Average age was 62.04 ± 21.18 years (median 68 years). Most of the patients were female (n = 558, 58.2%), Jewish (n = 827, 86.3%), and inpatients (n = 631, 65.9%). Only few ERCPs were performed emergently (n = 40, 4.2%). Twenty-Seven patients repeated the exam. Overall incidence of PEP/hyperamylasemia was 16.8% (n = 161); with a 5.6% (n = 54) incidence of hyperamylasemia and a 11.2% (n = 107) incidence of pancreatitis. Overall, 6 cases of severe pancreatitis were identified. The logistic regression analysis demonstrated that chronic use of statins is a protective factor in preventing development of PEP/hyperamylasemia [OR 0.436 [95%CI 0.303–0.627], p < 0.001]; Particularly, the PEP OR was of 0.318 [95%CI 0.169–0.597], p < 0.001 and the hyperamylasemia OR was of 0.565 [95%CI 0.372–0.859], p = 0.008. No significant predictor could be found for the risk of developing severe PEP.Conclusions: Our data support the possibility of exploiting statins as preventive agents for PEP. However, further studies, mainly RCTs, are warranted in order to replicate our findings.

show abstract

“…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%

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

et al. 2021

View full text Add to dashboard Cite

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.

show abstract

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

Cited by 4 publications

References 0 publications

Reduced risk of post ERCP pancreatitis in statin users

Reduced risk of post ERCP pancreatitis in statin users

Chronic Use of Statins and Their Effect on Prevention of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

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

Contact Info

Product

Resources

About