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Use of methimazole and risk of acute pancreatitis: A case-control study in Taiwan
Shih-Wei Lai1, Cheng-Li Lin2, Kuan-Fu Liao3
1School of Medicine, College of Medicine, China Medical University, Taichung, Hualien, Taiwan, China; Department of Family Medicine, China Medical University Hospital, Shenyang, China.
Objective:
Some cases of acute pancreatitis have been reported to be associated with use of methimazole. The aim of this study was to investigate the relationship between use of methimazole and risk of acute pancreatitis on the basis of a systematic analysis.
Methods:
This was a population-based case-control study analyzing the database of the Taiwan National Health Insurance Program. There were 5764 individuals aged 20-84 years with a first attack of acute pancreatitis from 1998 to 2011 as the cases and 23,056 randomly selected sex- and age-matched individuals without acute pancreatitis as the controls. Use of methimazole was categorized as "never use" and "ever use." We estimated the relative risk of acute pancreatitis associated with the use of methimazole by calculating the odds ratio (OR) with 95% confidence interval (CI) using a multivariable logistic regression model.
Results:
After adjustment for confounding factors, the OR of acute pancreatitis was 0.91 in individuals with ever use of methimazole, when compared with individuals with never use of methimazole (95% CI, 0.60-1.38). Unlike methimazole use, alcohol-related disease, biliary stone, cardiovascular disease, chronic obstructive pulmonary disease, diabetes mellitus, hepatitis B, hepatitis C, and hypertriglyceridemia were factors significantly associated with acute pancreatitis.
Conclusions:
Our study does not detect a substantial association between the use of methimazole and risk of acute pancreatitis on the basis of systematic analysis. There appears to be a discrepancy between case reports and our systematic analysis about the association between the use of methimazole and risk of acute pancreatitis.
Insights
This study found no significant link between methimazole use and acute pancreatitis risk. Previous case reports suggested a connection, but this large-scale analysis did not confirm it.
Area of Science:
- Endocrinology
- Gastroenterology
- Pharmacovigilance
Background:
- Case reports have suggested a potential association between methimazole use and acute pancreatitis.
- However, robust evidence to support this link has been limited.
Purpose of the Study:
- To systematically investigate the relationship between methimazole use and the risk of developing acute pancreatitis.
- To compare the findings with existing case reports.
Main Methods:
- A population-based case-control study utilizing the Taiwan National Health Insurance Program database (1998-2011).
- Included 5764 cases of first-attack acute pancreatitis and 23,056 matched controls.
- Analyzed methimazole use (never vs. ever) using multivariable logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI).
Main Results:
- The adjusted odds ratio (OR) for acute pancreatitis associated with ever using methimazole was 0.91 (95% CI, 0.60-1.38), indicating no substantial association.
- Factors significantly associated with acute pancreatitis included alcohol-related disease, biliary stones, cardiovascular disease, COPD, diabetes, hepatitis B, hepatitis C, and hypertriglyceridemia.
Conclusions:
- This systematic analysis did not detect a significant association between methimazole use and the risk of acute pancreatitis.
- A discrepancy exists between previous case reports and this large-scale study's findings regarding methimazole and pancreatitis risk.
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Assessment:
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include: