Hanna E. Bloomfield, MD, MPH
Do statins or fibrates affect risk for pancreatitis in adults?
Included studies evaluated the effect of statin or fibrate therapy on cardiovascular events, randomized ≥ 1000 adults, and had a mean follow-up of ≥ 1 year. Exclusion criteria included trials of patients who had previous organ transplantation or were receiving hemodialysis, or trials comparing combination therapy with placebo. Outcome was pancreatitis.
MEDLINE, EMBASE/Excerpta Medica, and Web of Science were searched for randomized controlled trials (RCTs) published between 1972 (fibrate trials) or 1994 (statin trials) and 9 June 2012. Reference lists of identified studies and the US Food and Drug Administration Web site were also searched. 21 RCTs of statins (n = 153 414, mean or median age 55 to 75 y, mean triglyceride level 118 to 187 mg/dL [1.33 to 2.11 mmol/L], weighted mean follow-up 4.3 y, median Jadad score 5 out of 5) and 7 RCTs of fibrates (n = 40 162, mean age 46 to 64 y, mean triglyceride level 145 to 184 mg/dL [1.64 to 2.08 mmol/L], weighted mean follow-up 5.3 y, all had Jadad scores of 5) met the selection criteria. Pancreatitis data were unpublished in 22 of the 28 studies.
Meta-analysis showed that statins reduced risk for pancreatitis compared with control (Table). Risk for pancreatitis did not differ between intensive- and moderate-dose statins or between fibrate and control (Table).
Statins reduce risk for pancreatitis in adults. Fibrates do not affect risk for pancreatitis.
Statins or fibrates vs control and risk for pancreatitis in adults*
*Abbreviations defined in Glossary. RRR, RRI, and CI calculated from control event rates and risk ratios in article using a random-effects model.
Bloomfield HE. Review: Statins reduce pancreatitis in adults with normal or mildly elevated triglyceride levels. Ann Intern Med. ;157:JC6–8. doi: 10.7326/0003-4819-157-12-201212180-02008
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Published: Ann Intern Med. 2012;157(12):JC6-8.
Cardiology, Coronary Risk Factors, Dyslipidemia, Gastroenterology/Hepatology, Pancreatic Disease.
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