title: Use of Simvastatin and Risk of Acute Pancreatitis: A Nationwide Case-Control Study in Taiwan.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.
authors.forename: Chih-Ming
authors.initials: CM
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.|College of Medicine, Tzu Chi University, Hualien, Taiwan.|Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Kuan-Fu
authors.initials: KF
authors.lastname: Liao
authors.affiliation: College of Medicine, China Medical University, Taichung, Taiwan.|Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: College of Medicine, China Medical University, Taichung, Taiwan.|Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010195:Pancreatitis / Q000139:chemically induced* / Q000453:epidemiology; D012307:Risk Factors; D019821:Simvastatin / Q000009:adverse effects*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000924:Anticholesteremic Agents; D019821:Simvastatin
keywords: Taiwan National Health Insurance Program; acute pancreatitis; simvastatin