S282 A Global Database Study on the Correlation Between Statin Use and the Incidence of Acute and Severe Acute Pancreatitis in Overweight and Obese Patients

Introduction: More than half of overweight and obese patients will need to take statins throughout their lives; however, these medications are often linked to side effects like myalgias, headaches, among others. Nonetheless, recent studies have found anti-inflammatory effects including down-regulation of pro-inflammatory cytokines and decrease of oxidative stress. Increased risk of acute pancreatitis (AP) in patients on statins has been reported, but these have been used to treat metabolic dysfunction-associated steatotic liver disease, prevent post-endoscopic retrograde cholangiopancreatography (ERCP) AP, and prevent diabetes after AP. We studied the correlation between statin use and the risk of AP and severe AP in overweight and obese patients. Methods: The global research database TriNetX comprises 96 health care organizations and over 315 million individual medical records providing de-identified data. Data from 2014 to 2024 were compiled. Over 95% of the patients were from health care organizations in the USA. Patients >18 years with a BMI >24.9 were included and comprehensive exclusion criteria (36 total) were made to homogenize the comparison groups and to control confounders. Patients had no previous pancreatic disease and had to be on any statins for at least 1 year and were followed longitudinally. The cohorts were 1:1 propensity score matched for age sex, race, body weight, and smoking status. Results: After matching, each cohort had 298,732 patients. The average age was 61.7 13.5 (SD), there were 50.1% women in each group, and 15.3% were African Americans. The risk of AP was significantly lower at 0.277% in patients on statins and 0.367% in patients not on statins, RR 1.325, 95% CI 1.211-1.450, P < 0.0001. Additionally, these patients also had a lower risk of severe AP and need to undergo ERCP (RR of 1.067, 95% CI 1.047-1.087, P < 0.0001, and RR of 1.669, 95% CI 1.461-1.907, P < 0.0001, respectively). Other AP complications, like pancreatic steatorrhea or pancreatectomy, were not analyzed due to their low number of cases. Conclusion: In this retrospective cohort, AP, severe AP and need to undergo ERCP were less common in patients on statins. Statins may control the increased risk of gallstones and hypertriglyceridemia in obese and overweight patients which can increase the risk of AP and may also have anti-inflammatory effects. Thus, statins may play a protective role against AP and severe AP in these patients which may outweigh the risks of the medication. More evidence to include statins as a cause of drug induced AP and the potential benefits in the treatment of AP with statins is necessary.