Use of thiopurines is not a risk factor for post-ERC pancreatitis in patients with primary sclerosing cholangitis

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Koskensalo , V , Aronen , P , Färkkilä , M , Kylänpää , L , Lindström , O , Rainio , M , Udd , M , Jokelainen , K & Tenca , A 2021 , ' Use of thiopurines is not a risk factor for post-ERC pancreatitis in patients with primary sclerosing cholangitis ' , Digestive and Liver Disease , vol. 53 , no. 8 , pp. 1020-1027 . https://doi.org/10.1016/j.dld.2021.05.009

Title: Use of thiopurines is not a risk factor for post-ERC pancreatitis in patients with primary sclerosing cholangitis
Author: Koskensalo, Vilja; Aronen, Pasi; Färkkilä, Martti; Kylänpää, Leena; Lindström, Outi; Rainio, Mia; Udd, Marianne; Jokelainen, Kalle; Tenca, Andrea
Contributor: University of Helsinki, Doctoral Programme in Clinical Research
University of Helsinki, HUS Helsinki and Uusimaa Hospital District
University of Helsinki, Centre of Excellence in Complex Disease Genetics
University of Helsinki, Department of Surgery
University of Helsinki, Department of Surgery
University of Helsinki, II kirurgian klinikka
University of Helsinki, Clinicum
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Abdominal Center
Date: 2021-08
Language: eng
Number of pages: 8
Belongs to series: Digestive and Liver Disease
ISSN: 1590-8658
URI: http://hdl.handle.net/10138/334381
Abstract: Introduction: Risk of post-ERC pancreatitis (PEP) in patients with primary sclerosing cholangitis (PSC) is 1-7.8%. PSC is often associated with inflammatory bowel disease and autoimmune hepatitis, which are usually treated with thiopurines. The role of thiopurines in PEP risk is still unclear. Aims and methods: We evaluated the thiopurine use in PEP. The data of 354 PSC patients who underwent 985 ERCs between 2009 and 2018 were collected. 177 patients treated with thiopurines (study group, SG) and 177 controls (CG) were matched with a propensity score (PSM). Odds ratios (ORs) with 95% confidence interval (95% CI) were calculated. Multivariable logistic regression analysis and generalized linear mixed model were performed. The P-value < 0.05 was significant. Results: In matched data, 472 ERCs were performed in SG and 513 in CG. Thiopurines were used in 373/472 (79.0%) ERCs in SG. The PEP rate was 5.3% in SG and 5.7% in CG ( p = 0.889). Unintentional pancreatic duct cannulation (OR 1.28, 95%CI 1.07-1.51, p = 0.004), and periampullary diverticulum (OR 4.87, 95%CI 1.72-11.98, p = 0.001) increased the risk of PEP. Conclusion: Prior or present thiopurine use did not increase the risk of PEP. (c) 2021 The Author(s). Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )
Subject: Endoscopic retrograde cholangiography
Post endoscopic retrograde cholangiography
pancreatitis
PEP
Primary sclerosing cholangitis
PSC
Thiopurines
Azathioprine
6-mercaptopurine
INFLAMMATORY-BOWEL-DISEASE
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
DRUG-INDUCED PANCREATITIS
EVIDENCE-BASED CONSENSUS
EUROPEAN-SOCIETY
AZATHIOPRINE
COMPLICATIONS
METRONIDAZOLE
MANAGEMENT
DIAGNOSIS
3121 General medicine, internal medicine and other clinical medicine
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