Patients with normal or slightly elevated triglycerides who receive statin therapy may be at reduced risk for developing pancreatitis, according to a recent meta-analysis.
Researchers evaluated data from six published and 22 unpublished studies assessing the efficacy of statin or fibrate therapy on cardiovascular events, including 21 statin and seven fibrate studies. Studies with at least 1,000 participants had more than 1 year of follow-up and were either controlled or dose-comparison trials. Incidents of pancreatitis and changes to patients’ triglyceride levels after 1 year were recorded.
Pancreatitis occurred in 309 participants out of 113,800 across 16 statin placebo- and standard care-controlled trials, including 134 treated patients and 175 controls (RR=0.77; 95% CI, 0.62-0.97). The condition developed in 156 patients out of 39,614 across five dose-comparison statin trials, including 70 patients who received an intensive dose and 86 who received a moderate dose (RR=0.82; 95% CI, 0.59-1.12). The combined RR for all 21 statin studies was 0.79 (95% CI, 0.65-0.95), with a number needed to treat of 1,187 patients during 5 years (95% CI, 731-4,768).
Across seven fibrate trials, 144 patients out of 40,162 developed pancreatitis, including 84 who received fibrate therapy and 60 who received placebo. Investigators calculated the RR for pancreatitis among fibrate patients as 1.39 (95% CI, 1.00-1.95), with a number needed to harm of 935 patients during 5 years (95% CI, 388 to >50,000).
Baseline triglycerides ranged from 118 mg/dL to 187 mg/dL in the statin studies and from 145 mg/dL to 184 mg/dL in the fibrate studies. No relationship was observed between changes in triglycerides and pancreatitis risk in either study set; researchers said limited statistical heterogeneity between trial-specific RRs reduced the analysis’ value.
“This report of pooled randomized trial data demonstrates that use of statin therapy was associated with a reduction in the number of patients developing pancreatitis,” the researchers concluded. “Broadly similar results were obtained for statin compared with placebo, as well as for intensive-dose statin therapy compared with moderate-dose therapy. … However, we did not demonstrate an association between use of fibrate therapy and risk of pancreatitis.”
Disclosure: See the study for a full list of relevant disclosures.