Chronic use of statins and risk of post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis

ABSTRACT

Background

There is limited evidence on the role of chronic statin therapy in the prevention of acute pancreatitis after ERCP. The aim of this meta-analysis was to evaluate the efficacy of statins in the prophylaxis of post-ERCP pancreatitis.

Research design and methods

Bibliographic search was performed through May 2020. The primary outcome was post-ERCP pancreatitis rate. An additional endpoint was the rate of severe pancreatitis.

Results

Nine studies, of which 1 prospective and 8 retrospective series, with 9374 patients were included. Baseline clinical and technical features were well balanced between the two study groups. Overall, pooled rate of post-ERCP pancreatitis was 4.8% (3.2%-6.4%) in the statin group and 7.1% (5.9%-8.3%) in the control group, with no difference in terms of pancreatitis rate (odds ratio 0.66, 95% confidence interval 0.43–1.02). This finding was confirmed in the multivariate analysis adjusted for several clinical and technical characteristics (adjusted odds ratio 0.68, 0.40–1.15). No difference was observed between the two study groups in terms of severe pancreatitis rate (odds ratio 1.07, 0.61–1.89).

Conclusions

Our meta-analysis seems to suggest the non-superiority of chronic statin therapy in preventing post-ERCP pancreatitis.

KEYWORDS:

• ERCP
• statin
• pancreas
• inflammation
• injury

Disclosures

Drs Antonio Facciorusso, Stefano Francesco Crinò, Matteo Tacelli, Filippo Antonini, Alberto Fantin, and Luca Barresi: None

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Antonio Facciorusso, Matteo Tacelli, Stefano Francesco Crinò, Luca Barresi were involved in the conception and design. Antonio Facciorusso and Matteo Tacelli were involved in the analysis and interpretation of the data. Antonio Facciorusso and Luca Barresi were involved in the drafting of the paper. Luca Barresi, Alberto Fantin, Filippo Antonini revised the manuscript critically for intellectual content. All of the authors approved the final version to be published and agree to be accountable for all aspects of the work.

Supplementary material

Supplemental data for this article can be accessed here.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This paper was not funded.