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14-12-2020 | Rheumatology | News | Article

RA linked to increased pancreatitis risk

Laura Cowen

medwireNews: People with rheumatoid arthritis (RA) have an increased risk for developing pancreatitis and pancreatic cancer compared with the general population, US study data show.

Motasem Alkhayyat (Cleveland Clinic Foundation, Ohio) and co-investigators also found that people with RA and pancreatitis tend to have worse outcomes than those who have pancreatitis alone.

The analysis included data for 56,183,720 individuals registered in 26 major integrated healthcare systems in the USA from 1999 to 2019.

Of these, 518,280 (0.92%) individuals aged 18 years and older had RA.

As reported in Rheumatology, the prevalence rates of new-onset acute pancreatitis, chronic pancreatitis, and pancreatic cancer were 1.10%, 0.39%, and 0.14%, respectively, among the people with RA.

By comparison, the rates were 0.73%, 0.21%, and 0.09%, respectively, in people without RA.

After adjusting for potential confounders, the researchers found that patients with RA were a significant 2.51 times more likely to develop acute pancreatitis, 2.97 times more likely to develop chronic pancreatitis, and 1.79 times more likely to develop pancreatic cancer relative to those without RA.

Among the patients with RA, those who used steroids were significantly more likely to develop acute pancreatitis than those who did not (odds ratio [OR]=3.82).

By contrast, RA patients who received DMARDs or biologic agents were significantly less likely to develop acute pancreatitis (OR=0.13 and 0.16, respectively) than those who did not receive such treatments.

For chronic pancreatitis and pancreatic cancer, the risks were significantly higher for RA patients with versus without DMARD (OR=1.52 and 1.18, respectively) and biologic (OR=1.35 and 1.28, respectively) use.

When investigating the outcomes of acute pancreatitis, Alkhayyat and team found that the patients with RA fared worse than those without RA. For example, the patients with RA were significantly more likely to develop sepsis, pneumonia, gastrointestinal bleeding, and ascites than those without RA.

Similarly, patients with RA had worse outcomes with chronic pancreatitis than those without RA, including higher rates of malnutrition, exocrine insufficiency, and diabetes.

Alkhayyat and co-authors say their findings suggest “that RA may be an independent risk factor for pancreatitis,” and believe the data “meaningfully add to the growing body of knowledge regarding the association between RA and pancreatic involvement.”

They conclude: “Further studies are required to better understand this association and the effect of medications used for RA.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group

Rheumatology 2020; doi:10.1093/rheumatology/keaa616

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