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

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.研究背景：目前针对原发性干燥综合征（primary Sjogren’s syndrome, pSS）患者罹患急性胰腺炎的风险相关研究较为有限。本研究基于中国台湾地区全人群队列，探讨pSS对急性胰腺炎发病风险的影响。 研究设计：基于人群的回顾性队列研究。 研究数据来源：本研究分析了2002年至2012年间覆盖中国台湾地区97%以上人口的全民健康保险申报数据。 研究对象：本研究通过中国台湾地区全民健康保险数据库的重大疾病登记系统，共筛选出9468例原发性干燥综合征患者；同时从普通人群中按照年龄（以5岁为组距）、性别及索引年份进行频率匹配，随机选取37872例对照个体。 主要结局指标：采用Cox比例风险回归模型（Cox proportional hazards regression models）分析急性胰腺炎的发病风险，模型校正了性别、年龄及合并症因素。 研究结果：本队列共纳入2374万研究对象，其中9468例原发性干燥综合征患者（女性占比87%，平均年龄55.6岁）及37872例对照个体，两组随访时间分别为4.64年及4.74年。原发性干燥综合征队列中共确诊44例急性胰腺炎病例，非原发性干燥综合征队列则为105例。多因素Cox比例风险回归分析显示，原发性干燥综合征队列的急性胰腺炎发病率显著高于非原发性干燥综合征队列（校正后风险比（adjusted HR, aHR）1.48，95%置信区间（95% confidence interval, CI）1.03~2.12）。使用环磷酰胺会增加急性胰腺炎的发病风险（aHR 5.27，95%CI 1.16~23.86）；与之相反，使用羟氯喹可降低该风险（aHR 0.23，95%CI 0.09~0.55）。 研究结论：这项全人群回顾性队列研究证实，原发性干燥综合征患者的急性胰腺炎发病风险显著高于普通人群。