Lin Chih-Ming, Liao Kuan-Fu, Lin Cheng-Li, Lai Shih-Wei
Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.
College of Medicine, Tzu Chi University, Hualien, Taiwan.
J Clin Pharmacol. 2017 Jul;57(7):918-923. doi: 10.1002/jcph.881. Epub 2017 Mar 16.
The correlation between simvastatin use and acute pancreatitis is explored. A case-control study was conducted to analyze claim data from the Taiwan National Health Insurance Program. The case group comprising a total of 3882 subjects aged 20 to 84 years with their first acute pancreatitis episode occurring between 1998 and 2011 formed the case group, against 3790 randomly selected controls matched for sex, age, comorbidities, and index year of acute pancreatitis diagnosis. Recent use of simvastatin was defined as subjects whose last remaining simvastatin tablet was noted ≤7 days before the date of acute pancreatitis diagnosis. Remote use of simvastatin was defined as subjects whose last remaining 1 tablet for simvastatin was noted >7 days before the date of acute pancreatitis diagnosis. Never use of simvastatin was defined as subjects who had never been prescribed simvastatin. A multivariable unconditional logistic regression model was used to estimate the odds ratio and 95%CI to explore the correlation between simvastatin use and acute pancreatitis. After adjustment for confounders, multivariable logistic regression analysis revealed that the adjusted odds ratio of acute pancreatitis was 1.3 for subjects with recent use of simvastatin (95%CI 1.02, 1.73), when compared with those with never use of simvastatin. The crude odds ratio decreased to 1.1 for those with remote use of simvastatin (95%CI 0.93, 1.34) but without statistical significance. Recent use of simvastatin is associated with acute pancreatitis. Clinicians should consider the possibility of simvastatin-associated acute pancreatitis for patients presenting for acute pancreatitis without known cause.
探讨了辛伐他汀使用与急性胰腺炎之间的相关性。开展了一项病例对照研究，以分析来自台湾国民健康保险计划的理赔数据。病例组由1998年至2011年间首次发生急性胰腺炎发作的3882名年龄在20至84岁的受试者组成，对照组为随机选取的3790名在性别、年龄、合并症以及急性胰腺炎诊断索引年份方面相匹配的对照者。辛伐他汀近期使用定义为在急性胰腺炎诊断日期前≤7天记录到最后剩余一片辛伐他汀片的受试者。辛伐他汀远期使用定义为在急性胰腺炎诊断日期前>7天记录到最后剩余一片辛伐他汀片的受试者。从未使用辛伐他汀定义为从未被开具过辛伐他汀处方的受试者。采用多变量无条件逻辑回归模型来估计比值比和95%置信区间，以探讨辛伐他汀使用与急性胰腺炎之间的相关性。在对混杂因素进行调整后，多变量逻辑回归分析显示，与从未使用辛伐他汀的受试者相比，近期使用辛伐他汀的受试者发生急性胰腺炎的调整后比值比为1.3（95%置信区间1.02, 1.73）。辛伐他汀远期使用者的粗比值比降至1.1（95%置信区间0.93, 1.34），但无统计学意义。近期使用辛伐他汀与急性胰腺炎相关。对于病因不明的急性胰腺炎患者，临床医生应考虑辛伐他汀相关性急性胰腺炎的可能性。
