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Acid-suppressing drugs and gastroesophageal reflux disease as risk factors for acute pancreatitis--results from a Swedish Case-Control Study.
Pharmacoepidemiol Drug Saf 2006; 15(3):141-9PD

Abstract

PURPOSE

To study risk factors for acute pancreatitis, here with emphasis on gastro-intestinal diseases and their treatments.

METHODS

Population based case-control study covering four areas in Sweden encompassing 2.2 million inhabitants. Included were 462 incident cases of acute pancreatitis aged 20-85 years, hospitalized from 1 January 1995-31 May 1998, and 1,781 unmatched controls randomly selected from the study base using a population register. Information was captured from medical records and structured telephone interviews.

RESULTS

Current use of H(2) antagonists starting within 6 months of index-date was associated with acute pancreatitis with an adjusted OR of 4.9 (95% confidence interval (CI) 1.6-15), and current use of proton pump inhibitors (PPIs) with an adjusted OR of 3.2 (95%CI 1.4-7.4). For both drug classes, the ORs tended to be higher at higher doses. Gastritis/gastro-esophageal reflux disease (GERD) within the last 12 months not treated with PPIs or H(2)-antagonists and inflammatory bowel disease (IBD) not treated with anti-inflammatory or immunosuppressive drugs were associated with development of acute pancreatitis with adjusted odds ratios (OR) of 1.9 (95%CI 1.2-3.0) and 5.1 (95%CI 2.0-13) respectively.

CONCLUSIONS

Current IBD without treatment and gastritis/GERD without treatment were found to be associated with increased risks to develop acute pancreatitis but the nature of the latter association needs to be further evaluated. On balance, we judge that the observed associations between current use of H(2)-antagonists and PPIs and increased risk of acute pancreatitis are unlikely to be explained by bias.

Authors+Show Affiliations

Medical Products Agency, Uppsala, Sweden. Anders.Sundstrom@Mpa.seNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16200654

Citation

Sundström, Anders, et al. "Acid-suppressing Drugs and Gastroesophageal Reflux Disease as Risk Factors for Acute Pancreatitis--results From a Swedish Case-Control Study." Pharmacoepidemiology and Drug Safety, vol. 15, no. 3, 2006, pp. 141-9.
Sundström A, Blomgren K, Alfredsson L, et al. Acid-suppressing drugs and gastroesophageal reflux disease as risk factors for acute pancreatitis--results from a Swedish Case-Control Study. Pharmacoepidemiol Drug Saf. 2006;15(3):141-9.
Sundström, A., Blomgren, K., Alfredsson, L., & Wiholm, B. E. (2006). Acid-suppressing drugs and gastroesophageal reflux disease as risk factors for acute pancreatitis--results from a Swedish Case-Control Study. Pharmacoepidemiology and Drug Safety, 15(3), pp. 141-9.
Sundström A, et al. Acid-suppressing Drugs and Gastroesophageal Reflux Disease as Risk Factors for Acute Pancreatitis--results From a Swedish Case-Control Study. Pharmacoepidemiol Drug Saf. 2006;15(3):141-9. PubMed PMID: 16200654.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acid-suppressing drugs and gastroesophageal reflux disease as risk factors for acute pancreatitis--results from a Swedish Case-Control Study. AU - Sundström,Anders, AU - Blomgren,Kerstin, AU - Alfredsson,Lars, AU - Wiholm,Bengt-Erik, PY - 2005/10/4/pubmed PY - 2006/12/9/medline PY - 2005/10/4/entrez SP - 141 EP - 9 JF - Pharmacoepidemiology and drug safety JO - Pharmacoepidemiol Drug Saf VL - 15 IS - 3 N2 - PURPOSE: To study risk factors for acute pancreatitis, here with emphasis on gastro-intestinal diseases and their treatments. METHODS: Population based case-control study covering four areas in Sweden encompassing 2.2 million inhabitants. Included were 462 incident cases of acute pancreatitis aged 20-85 years, hospitalized from 1 January 1995-31 May 1998, and 1,781 unmatched controls randomly selected from the study base using a population register. Information was captured from medical records and structured telephone interviews. RESULTS: Current use of H(2) antagonists starting within 6 months of index-date was associated with acute pancreatitis with an adjusted OR of 4.9 (95% confidence interval (CI) 1.6-15), and current use of proton pump inhibitors (PPIs) with an adjusted OR of 3.2 (95%CI 1.4-7.4). For both drug classes, the ORs tended to be higher at higher doses. Gastritis/gastro-esophageal reflux disease (GERD) within the last 12 months not treated with PPIs or H(2)-antagonists and inflammatory bowel disease (IBD) not treated with anti-inflammatory or immunosuppressive drugs were associated with development of acute pancreatitis with adjusted odds ratios (OR) of 1.9 (95%CI 1.2-3.0) and 5.1 (95%CI 2.0-13) respectively. CONCLUSIONS: Current IBD without treatment and gastritis/GERD without treatment were found to be associated with increased risks to develop acute pancreatitis but the nature of the latter association needs to be further evaluated. On balance, we judge that the observed associations between current use of H(2)-antagonists and PPIs and increased risk of acute pancreatitis are unlikely to be explained by bias. SN - 1053-8569 UR - https://www.unboundmedicine.com/medline/citation/16200654/Acid_suppressing_drugs_and_gastroesophageal_reflux_disease_as_risk_factors_for_acute_pancreatitis__results_from_a_Swedish_Case_Control_Study_ L2 - https://doi.org/10.1002/pds.1137 DB - PRIME DP - Unbound Medicine ER -