Razavi Dan, Lindblad Mats, Bexelius Tomas, Oskarsson Viktor, Sadr-Azodi Omid, Ljung Rickard
Division of Surgery, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
Section of Upper Gastrointestinal Surgery, Centre of Gastrointestinal Disease, Karolinska University Hospital, Stockholm, Sweden.
Pharmacoepidemiol Drug Saf. 2016 Nov;25(11):1337-1341. doi: 10.1002/pds.4109. Epub 2016 Sep 21.
Drug-induced pancreatitis is receiving increased medical and epidemiological attention. However, as no study has examined the role of polypharmacy per se in the development of acute pancreatitis, we examined the association between polypharmacy and risk of acute pancreatitis.
A nationwide case-control study was conducted between 2006 and 2008 of Swedish people aged 40-84 years. The Swedish Patient Register was used to identify 6161 cases of first-episode acute pancreatitis. The Swedish Register of the Total Population was used to randomly select 61 637 controls from the general population using frequency-based density sampling, matched for age, sex, and calendar year. The Swedish Prescribed Drug Register was used to assess polypharmacy, defined as the number of unique drugs prescribed during the last 6 months before the index date (i.e. the date of acute pancreatitis for cases and a random date for controls). Odds ratios (ORs), with 95% confidence intervals (CIs), of acute pancreatitis were estimated by unconditional logistic regression, adjusted for matching variables and potential confounding factors.
The number of prescribed drugs was associated with a dose-dependent increase in the risk of acute pancreatitis. In the multivariable-adjusted model, compared to those without any prescriptions, the OR was 1.69 (95%CI: 1.55-1.86) for persons with 1-2 drugs, 2.40 (2.20-2.62) for 3-5 drugs, 3.17 (2.88-3.48) for 6-9 drugs, and 4.57 (4.12-5.06) for 10 or more drugs.
This population-based case-control study shows a dose-dependent association between increasing polypharmacy and risk of acute pancreatitis. These findings provide further insights into drug-induced pancreatitis. Copyright © 2016 John Wiley & Sons, Ltd.
药物性胰腺炎正受到越来越多的医学和流行病学关注。然而，由于尚无研究探讨联合用药本身在急性胰腺炎发病中的作用，我们研究了联合用药与急性胰腺炎风险之间的关联。
2006年至2008年对瑞典40 - 84岁人群进行了一项全国性病例对照研究。利用瑞典患者登记册确定6161例首发急性胰腺炎病例。使用瑞典总人口登记册，通过基于频率的密度抽样从普通人群中随机选取61637名对照，按年龄、性别和日历年进行匹配。利用瑞典处方药登记册评估联合用药情况，联合用药定义为索引日期（即病例的急性胰腺炎发病日期和对照的随机日期）前6个月内开具的独特药物数量。通过无条件逻辑回归估计急性胰腺炎的比值比（OR）及95%置信区间（CI），并对匹配变量和潜在混杂因素进行调整。
开具的药物数量与急性胰腺炎风险呈剂量依赖性增加。在多变量调整模型中，与未开具任何处方的人相比，开具1 - 2种药物的人的OR为1.69（95%CI：1.55 - 1.86），开具3 - 5种药物的人为2.40（2.20 - 2.62），开具6 - 9种药物的人为3.17（2.88 - 3.48），开具10种或更多药物的人为4.57（4.12 - 5.06）。
这项基于人群的病例对照研究表明，联合用药增加与急性胰腺炎风险之间存在剂量依赖性关联。这些发现为药物性胰腺炎提供了进一步的见解。版权所有© 2016约翰威立父子有限公司。
