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Primary Sjogren’s syndrome and the risk of acute pancreatitis: a nationwide cohort study.

Primary Sjogren’s syndrome and the risk of acute pancreatitis: a nationwide cohort study.
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Chang CC, Chang YS, Wang SH, Lin SY, Chen YH, Chen JH,


Chang CC, Chang YS, Wang SH, Lin SY, Chen YH, Chen JH, (click to view)

Chang CC, Chang YS, Wang SH, Lin SY, Chen YH, Chen JH,

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BMJ open 2017 08 117(8) e014807 doi 10.1136/bmjopen-2016-014807
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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