title: Zopiclone use associated with increased risk of acute pancreatitis: a case-control study in Taiwan.
abstract: BACKGROUND
  The purpose of this study was to assess the relationship between zopiclone use and the risk of acute pancreatitis in Taiwan.
  
  
  METHODS
  This was a population-based case-control study. The data source was from the database of the Taiwan National Health Insurance Program since 2000-2011. We identified 5169 subjects aged 20-84 years with a first-time attack of acute pancreatitis as the patients and 20,676 sex-matched and age-matched subjects without acute pancreatitis as the controls. Active use of zopiclone was defined as subjects who received at least one prescription for zopiclone within 30 days before the date of diagnosing acute pancreatitis. The lack of zopiclone prescription was defined as 'never use'. We calculated the odds ratio (OR) and 95% confidence interval (CI) to assess the risk of acute pancreatitis associated with zopiclone use by the multivariable logistic regression model.
  
  
  RESULTS
  After adjustment for potential confounding variables, the adjusted OR of acute pancreatitis was 2.36 for subjects with active use of zopiclone (95% CI 1.70-3.28), as compared with those with never use of zopiclone. In further analysis, as a reference of subjects with never use of zopiclone and without alcohol-related disease and biliary stone, the adjusted OR increased to 14.44 in those with active use of zopiclone and with alcohol-related disease or biliary stone (95% CI 7.47-27.89).
  
  
  CONCLUSIONS
  Subjects actively using zopiclone are associated with increased risk of acute pancreatitis. Clinicians should take acute pancreatitis risk into account when prescribing zopiclone, particularly comorbid with alcohol-related disease or biliary stone.
authors.affiliation: College of Medicine, China Medical University, Taichung, Taiwan.|Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: S-W
authors.initials: SW
authors.lastname: Lai
authors.affiliation: College of Chinese Medicine, China Medical University, Taichung, Taiwan.|Division of Hepato-gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: H-C
authors.initials: HC
authors.lastname: Lai
authors.affiliation: College of Medicine, China Medical University, Taichung, Taiwan.|Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: C-L
authors.initials: CL
authors.lastname: Lin
authors.affiliation: College of Medicine, Tzu Chi University, Hualien, Taiwan.|Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.|Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
authors.forename: K-F
authors.initials: KF
authors.lastname: Liao
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000150:complications; D053961:Azabicyclo Compounds / Q000009:adverse effects*; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007669:Kidney Calculi / Q000150:complications; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010195:Pancreatitis / Q000139:chemically induced*; D010879:Piperazines / Q000009:adverse effects*; D012307:Risk Factors; D013624:Taiwan; D055815:Young Adult
chemical_list: D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; C515050:zopiclone