The relationship between the use of statins and mortality, severity, and pancreatic cancer in Danish patients with chronic pancreatitis

Eur J Gastroenterol Hepatol. 2018 Mar;30(3):346-351. doi: 10.1097/MEG.0000000000001060.

Abstract

Objectives: Chronic pancreatitis (CP) is associated with a shortened life expectancy. Statins have anti-inflammatory properties and we aimed to evaluate the association between the use of statins and the risk of death, progression of CP, and pancreatic cancer in patients with CP.

Patients and methods: We carried out a nested case-cohort study and included patients with CP. We used claims of proton pump inhibitors as an active comparator. Patients with cirrhosis or cancer were excluded. We evaluated the exposure on the basis of pharmacy claims of statins. We used propensity score matching with a statins : nonstatins ratio of 1 : 1.

Results: A total of 4807 patients were eligible for propensity score matching; 33% were women and the mean (SD) age at cohort entry was 56 (10) years. During follow-up, a total of 2073 (43%) patients had died and the risk of death was significantly lower among patients using statins versus no statins among 678 matched patients [hazard ratio (HR) 0.64; 95% confidence interval (CI): 0.49-0.83]. Use of statins versus no statins was associated with decreased progression of CP, with an HR of 0.21 (95% CI: 0.17-0.26). Pancreatic cancer occurred in 117 (2.4%) patients and we found a lower risk of pancreatic cancer in statin-treated patients compared with no statins, with a HR of 0.21 (95% CI: 0.06-0.70).

Conclusion: In this nationwide study, we found lower risks of mortality, disease progression, and pancreatic cancer in patients with CP using statins. The study is limited by its retrospective design, but supports the hypothesis that statins may affect the course of CP.

MeSH terms

  • Adult
  • Aged
  • Cause of Death
  • Denmark / epidemiology
  • Disease Progression
  • Drug Utilization / statistics & numerical data
  • Endpoint Determination
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / epidemiology
  • Pancreatic Neoplasms / etiology
  • Pancreatic Neoplasms / prevention & control*
  • Pancreatitis, Chronic / complications
  • Pancreatitis, Chronic / drug therapy*
  • Pancreatitis, Chronic / mortality
  • Propensity Score
  • Registries
  • Retrospective Studies
  • Severity of Illness Index
  • Socioeconomic Factors

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors