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Primary Sjogren’s syndrome and the risk of acute pancreatitis: a nationwide cohort study
  1. Chi-Ching Chang1,2,
  2. Yu-Sheng Chang2,3,
  3. Shu-Hung Wang3,
  4. Shyr-Yi Lin4,5,
  5. Yi-Hsuan Chen6,
  6. Jin Hua Chen6,7
  1. 1 Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
  2. 2 Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  3. 3 Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
  4. 4 Department of Primary Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan
  5. 5 Department of General Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  6. 6 Biostatistics Centre College of Management, Taipei Medical University, Taipei, Taiwan
  7. 7 Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei, Taiwan
  1. Correspondence to Professor Jin Hua Chen; jh_chen{at}tmu.edu.tw

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.

  • primary Sjogren’s syndrome
  • risk
  • acute pancreatitis

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors C-CC contributed to the conception and design of the work, drafting of the article, revision of the article critically for crucial intellectual content, and final approval of the version to be published. Y-SC contributed to interpretation of data, revision of the article critically for crucial intellectual content, and final approval of the version to be published. S-HW and S-YL contributed to the analysis of data, revision of the article critically for crucial intellectual content, and final approval of the version to be published. Y-HC contributed to the analysis of the data, drafting of the article, and final approval of the version to be published. J-HC designed the study and conceived the work, completed the analysis, revised the article critically for crucial intellectual content and corresponded for final approval of the version to be published. All authors have disclosed any potential competing financial interests regarding the submitted article.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Extra data can be accessed via the Dryad data repository at http://datadryad.org/ with the doi:10.5061/dryad.22h7c.

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