Chronic use of statins and risk of post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis

Expert Rev Gastroenterol Hepatol. 2021 Feb;15(2):195-202. doi: 10.1080/17474124.2021.1829471. Epub 2020 Oct 12.

Abstract

Background: There is limited evidence on the role of chronic statin therapy in the prevention of acute pancreatitis after ERCP. The aim of this meta-analysis was to evaluate the efficacy of statins in the prophylaxis of post-ERCP pancreatitis.

Research design and methods: Bibliographic search was performed through May 2020. The primary outcome was post-ERCP pancreatitis rate. An additional endpoint was the rate of severe pancreatitis.

Results: Nine studies, of which 1 prospective and 8 retrospective series, with 9374 patients were included. Baseline clinical and technical features were well balanced between the two study groups. Overall, pooled rate of post-ERCP pancreatitis was 4.8% (3.2%-6.4%) in the statin group and 7.1% (5.9%-8.3%) in the control group, with no difference in terms of pancreatitis rate (odds ratio 0.66, 95% confidence interval 0.43-1.02). This finding was confirmed in the multivariate analysis adjusted for several clinical and technical characteristics (adjusted odds ratio 0.68, 0.40-1.15). No difference was observed between the two study groups in terms of severe pancreatitis rate (odds ratio 1.07, 0.61-1.89).

Conclusions: Our meta-analysis seems to suggest the non-superiority of chronic statin therapy in preventing post-ERCP pancreatitis.

Keywords: ERCP; inflammation; injury; pancreas; statin.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Video-Audio Media

MeSH terms

  • Acute Disease
  • Cholangiopancreatography, Endoscopic Retrograde*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Pancreatitis / prevention & control*
  • Postoperative Complications / prevention & control*

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors