Abstract

Objective Studies on the risk of acute pancreatitis in patients with primary Sjogren's syndrome (pSS) are limited. We evaluated the effects of pSS on the risk of acute pancreatitis in a nationwide, population-based cohort in Taiwan. Study design Population-based retrospective cohort study. Setting We studied the claims data of the >97% Taiwan population from 2002 to 2012. Participants We identified 9468 patients with pSS by using the catastrophic illness registry of the National Health Insurance Database in Taiwan. We also selected 37 872 controls that were randomly frequency matched by age (in 5 year bands), sex and index year from the general population. Primary outcome measure We analysed the risk of acute pancreatitis by using Cox proportional hazards regression models including sex, age and comorbidities. Results From 23.74 million people in the cohort, 9468 patients with pSS (87% women, mean age=55.6 years) and 37 872 controls were followed-up for 4.64 and 4.74 years, respectively. A total of 44 cases of acute pancreatitis were identified in the pSS cohort versus 105 cases in the non-pSS cohort. Multivariate Cox regression analysis indicated that the incidence rate of acute pancreatitis was significantly higher in the pSS cohort than in the non-pSS cohort (adjusted HR (aHR) 1.48, 95% CI 1.03 to 2.12). Cyclophosphamide use increased the risk of acute pancreatitis (aHR 5.27, 95% CI 1.16 to 23.86). By contrast, hydroxychloroquine reduced the risk of acute pancreatitis (aHR 0.23, 95% CI 0.09 to 0.55). Conclusion This nationwide, retrospective cohort study demonstrated that the risk of acute pancreatitis was significantly higher in patients with pSS than in the general population.

Original languageEnglish
Article numbere014807
JournalBMJ Open
Volume7
Issue number8
DOIs
Publication statusPublished - Aug 1 2017

Fingerprint

Sjogren's Syndrome
Pancreatitis
Cohort Studies
Taiwan
Population
Catastrophic Illness
Retrospective Studies
Hydroxychloroquine
National Health Programs
Proportional Hazards Models
Cyclophosphamide
Registries
Comorbidity
Regression Analysis
Outcome Assessment (Health Care)
Databases
Incidence

Keywords

  • acute pancreatitis
  • primary Sjogren's syndrome
  • risk

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Primary Sjogren's syndrome and the risk of acute pancreatitis : A nationwide cohort study. / Chang, Chi Ching; Chang, Yu Sheng; Wang, Shu Hung; Lin, Shyr Yi; Chen, Yi Hsuan; Chen, Jin Hua.

In: BMJ Open, Vol. 7, No. 8, e014807, 01.08.2017.

Research output: Contribution to journalArticle

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title = "Primary Sjogren's syndrome and the risk of acute pancreatitis: A nationwide cohort study",
abstract = "Objective Studies on the risk of acute pancreatitis in patients with primary Sjogren's syndrome (pSS) are limited. We evaluated the effects of pSS on the risk of acute pancreatitis in a nationwide, population-based cohort in Taiwan. Study design Population-based retrospective cohort study. Setting We studied the claims data of the >97{\%} Taiwan population from 2002 to 2012. Participants We identified 9468 patients with pSS by using the catastrophic illness registry of the National Health Insurance Database in Taiwan. We also selected 37 872 controls that were randomly frequency matched by age (in 5 year bands), sex and index year from the general population. Primary outcome measure We analysed the risk of acute pancreatitis by using Cox proportional hazards regression models including sex, age and comorbidities. Results From 23.74 million people in the cohort, 9468 patients with pSS (87{\%} women, mean age=55.6 years) and 37 872 controls were followed-up for 4.64 and 4.74 years, respectively. A total of 44 cases of acute pancreatitis were identified in the pSS cohort versus 105 cases in the non-pSS cohort. Multivariate Cox regression analysis indicated that the incidence rate of acute pancreatitis was significantly higher in the pSS cohort than in the non-pSS cohort (adjusted HR (aHR) 1.48, 95{\%} CI 1.03 to 2.12). Cyclophosphamide use increased the risk of acute pancreatitis (aHR 5.27, 95{\%} CI 1.16 to 23.86). By contrast, hydroxychloroquine reduced the risk of acute pancreatitis (aHR 0.23, 95{\%} CI 0.09 to 0.55). Conclusion This nationwide, retrospective cohort study demonstrated that the risk of acute pancreatitis was significantly higher in patients with pSS than in the general population.",
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T1 - Primary Sjogren's syndrome and the risk of acute pancreatitis

T2 - A nationwide cohort study

AU - Chang, Chi Ching

AU - Chang, Yu Sheng

AU - Wang, Shu Hung

AU - Lin, Shyr Yi

AU - Chen, Yi Hsuan

AU - Chen, Jin Hua

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N2 - Objective Studies on the risk of acute pancreatitis in patients with primary Sjogren's syndrome (pSS) are limited. We evaluated the effects of pSS on the risk of acute pancreatitis in a nationwide, population-based cohort in Taiwan. Study design Population-based retrospective cohort study. Setting We studied the claims data of the >97% Taiwan population from 2002 to 2012. Participants We identified 9468 patients with pSS by using the catastrophic illness registry of the National Health Insurance Database in Taiwan. We also selected 37 872 controls that were randomly frequency matched by age (in 5 year bands), sex and index year from the general population. Primary outcome measure We analysed the risk of acute pancreatitis by using Cox proportional hazards regression models including sex, age and comorbidities. Results From 23.74 million people in the cohort, 9468 patients with pSS (87% women, mean age=55.6 years) and 37 872 controls were followed-up for 4.64 and 4.74 years, respectively. A total of 44 cases of acute pancreatitis were identified in the pSS cohort versus 105 cases in the non-pSS cohort. Multivariate Cox regression analysis indicated that the incidence rate of acute pancreatitis was significantly higher in the pSS cohort than in the non-pSS cohort (adjusted HR (aHR) 1.48, 95% CI 1.03 to 2.12). Cyclophosphamide use increased the risk of acute pancreatitis (aHR 5.27, 95% CI 1.16 to 23.86). By contrast, hydroxychloroquine reduced the risk of acute pancreatitis (aHR 0.23, 95% CI 0.09 to 0.55). Conclusion This nationwide, retrospective cohort study demonstrated that the risk of acute pancreatitis was significantly higher in patients with pSS than in the general population.

AB - Objective Studies on the risk of acute pancreatitis in patients with primary Sjogren's syndrome (pSS) are limited. We evaluated the effects of pSS on the risk of acute pancreatitis in a nationwide, population-based cohort in Taiwan. Study design Population-based retrospective cohort study. Setting We studied the claims data of the >97% Taiwan population from 2002 to 2012. Participants We identified 9468 patients with pSS by using the catastrophic illness registry of the National Health Insurance Database in Taiwan. We also selected 37 872 controls that were randomly frequency matched by age (in 5 year bands), sex and index year from the general population. Primary outcome measure We analysed the risk of acute pancreatitis by using Cox proportional hazards regression models including sex, age and comorbidities. Results From 23.74 million people in the cohort, 9468 patients with pSS (87% women, mean age=55.6 years) and 37 872 controls were followed-up for 4.64 and 4.74 years, respectively. A total of 44 cases of acute pancreatitis were identified in the pSS cohort versus 105 cases in the non-pSS cohort. Multivariate Cox regression analysis indicated that the incidence rate of acute pancreatitis was significantly higher in the pSS cohort than in the non-pSS cohort (adjusted HR (aHR) 1.48, 95% CI 1.03 to 2.12). Cyclophosphamide use increased the risk of acute pancreatitis (aHR 5.27, 95% CI 1.16 to 23.86). By contrast, hydroxychloroquine reduced the risk of acute pancreatitis (aHR 0.23, 95% CI 0.09 to 0.55). Conclusion This nationwide, retrospective cohort study demonstrated that the risk of acute pancreatitis was significantly higher in patients with pSS than in the general population.

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