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News

Risk of acute pancreatitis in users of azathioprine

There is a substantially increased risk of acute pancreatitis in users of azathioprine, find researchers in the June issue of the American Journal of Gastroenterology.

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It has been suggested that use of azathioprine is linked to acute pancreatitis in several cases.

In this study, researchers from Denmark examined the risk of acute pancreatitis in users of azathioprine in North Jutland County, Denmark. This is an area with approximately 490,000 inhabitants.

The research team identified incident cases of acute pancreatitis from the county's Hospital Discharge Registry, between 1991 and 2000. They selected 10 controls per case, which were matched by age and sex, from the Central Personal Registry using incidence density sampling technique.

In addition, the team collected data on all prescriptions of azathioprine, within 90 days before admission, from the population-based North Jutland Prescription Database.

The team also collected data on potential confounders from the registries, and used conditional logistic regression to adjust for confounding.

Overall, the team included 1,388 patients and 13,836 controls in the study.

Adjusted OR of having redeemed prescriptions for azathioprine within 90 days before admission for acute pancreatitis was 8.4.
American Journal of Gastroenterology

They found that 1,317 individuals redeemed a total of 15,811 azathioprine prescriptions.

The researchers also found that the incidence rate for acute pancreatitis in users of azathioprine was 1 per 659 treatment year.

They calculated that the crude odds ratio (OR) of having redeemed prescriptions for azathioprine within 90 days before admission for acute pancreatitis was 7.5.

However, after adjustment for gallstone disease, alcohol-related diseases, inflammatory bowel disease, and use of glucocorticoids, the OR increased to 8.4.

The team determined that the population-attributable risk - the proportion of pancreatitis cases attributable to the use of azathioprine in the study population - was 0.4%.

Dr Andrea Floyd's team concluded, "There was a substantially increased relative risk of acute pancreatitis in users of azathioprine".

Am J Gastroenterol 2003; 98(6): 1305-8
23 June 2003

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