title: Tamoxifen use and acute pancreatitis: A population-based cohort study.
abstract: BACKGROUND
  Several case reports have indicated that tamoxifen induced acute pancreatitis (AP); but no pharmacoepidemiological data support the claim. Therefore, we investigated whether tamoxifen use is correlated with the risk of AP in patients with breast cancer.
  
  
  METHODS
  This population-based cohort study used the Taiwan National Health Insurance Research Database. A cohort of 22 005 patients aged ≥20 years with breast cancer from January 1, 2000 to December 31, 2009 was identified and the date of cancer diagnosis was set as the index date. The end point was developing AP during the follow-up. Hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated to determine the correlation between the risk of AP and tamoxifen use. Because the drug use varied over time, it was measured as a time-dependent covariate in the Cox proportional hazard model. The same approaches were applied in PS-matched cohorts.
  
  
  RESULTS
  After adjustment for covariates and medication use including fluorouracil and doxorubicin, the risk of AP was not significant between tamoxifen users and tamoxifen nonusers (adjusted HR = 0.94, 95% CI = 0.74-1.19) in the non-matching cohorts. The results revealed no dose-response trend between tamoxifen use and the risk of AP (adjusted HR = 0.98, 95% CI = 0.96-1.00). The comorbidities DM and gallstones were associated with a significantly increased risk of AP. Similar trends were observed in PS-matched cohorts.
  
  
  CONCLUSIONS
  No significant correlation was observed between tamoxifen use and the risk of AP in patients with breast cancer.
authors.affiliation: School of Pharmacy, China Medical University, Taichung, Taiwan.|Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Fan-Gen
authors.initials: FG
authors.lastname: Hsu
authors.affiliation: School of Pharmacy, China Medical University, Taichung, Taiwan.|Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Yow-Wen
authors.initials: YW
authors.lastname: Hsieh
authors.affiliation: School of Pharmacy, China Medical University, Taichung, Taiwan.
authors.forename: Ming-Jyh
authors.initials: MJ
authors.lastname: Sheu
authors.affiliation: Healthcare Service Research Center (HSRC), Taichung Veterans General Hospital, Taichung, Taiwan.|Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Che-Chen
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
authors.forename: Chung Y
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: College of Medicine, The School of Chinese Medicine for Post Baccalaureate, I-Shou University (Yancho Campus), Kaohsiung, Taiwan.|Department of Chinese Medicine, E-DA Hospital, Kaohsiung, Taiwan.
authors.forename: Chang-Yin
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Medical Laboratory Science and Biotechnology, School of Medical and Health Sciences, Fooyin University, Kaohsiung, Taiwan.
authors.forename: Mei-Yin
authors.initials: MY
authors.lastname: Chang
authors.affiliation: Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.
authors.forename: Kuang-Hsi
authors.identifier: http://orcid.org/0000-0002-6772-3356
authors.initials: KH
authors.lastname: Chang
mesh_terms: D000208:Acute Disease; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced*; D013624:Taiwan; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D013629:Tamoxifen