Statin Therapy and Pancreatitis: A Multi-Institutional Retrospective Analysis

Caroline E O'Connor; Brittany Q Dang; Brittany Miles; James Mackey

doi:10.7759/cureus.51723

Statin Therapy and Pancreatitis: A Multi-Institutional Retrospective Analysis

Cureus. 2024 Jan 5;16(1):e51723. doi: 10.7759/cureus.51723. eCollection 2024 Jan.

Authors

Caroline E O'Connor¹, Brittany Q Dang¹, Brittany Miles², James Mackey³

Affiliations

¹ Internal Medicine, University of Texas Medical Branch, Galveston, USA.
² Radiology, Baylor University Medical Center, Dallas, USA.
³ Hematology and Oncology, Baylor University Medical Center, Dallas, USA.

Abstract

Introduction: Acute pancreatitis is a serious condition that has numerous etiologies and often requires hospital admission due to its high mortality rates. Statins are used worldwide to reduce the risk of cardiovascular disease. Some studies have shown an association between long-term statin use and acute pancreatitis. However, other studies have shown no effect or even postulated a mild protective effect. Due to conflicting information in the medical literature, the relationship between statins and acute pancreatitis remains unclear. The current study uses the TriNetX global research database to further investigate the impact of statin use on the development of acute pancreatitis over a five-year period.

Methods: Two cohorts were created using the TriNetX global research database. One group consisted of patients not taking statins, while the other group included patients taking any statins. Patients in both groups were required to be between the ages of 40 and 75 and had normal low-density lipoprotein cholesterol (LDL) (≤200 mg/dl) and triglyceride (≤150 mg/dl) levels. Patients were matched for age, gender, race, and comorbidities. The statin group was then compared to the no-statin group and measured for the outcome of the incidence of acute pancreatitis and the frequency of episodes within the first five years of statin use. Patients who experienced any acute pancreatitis episode before starting statin therapy or before meeting inclusion criteria were excluded from the study.

Results: Patients on statin therapy were significantly more likely to develop acute pancreatitis compared to patients not taking statin therapy (risk ratio 1.332, 95% CI: 1.242-1.429, P<0.0001). However, the statin group had a lower mean number of pancreatitis episodes than the no-statin group (4.6 vs. 5.3, P=0.043).

Conclusion: The results from this large global dataset support the previously established idea that prolonged use of statins is associated with an increased risk of pancreatitis. Clinicians should strongly consider statin-induced pancreatitis when other common etiologies have been ruled out.

Keywords: acute pancreatitis; drug-induced pancreatitis; inflammation; lipid-lowering agents; statins.