Patients with celiac disease (CD) appear to be at increased risk for pancreatitis, especially acute pancreatitis, according to data from a retrospective study presented at the 2020 American College of Gastroenterology (ACG) Annual Scientific Meeting. Although patients with CD are known to be at increased risk for pancreatitis, the degree of risk is not known in the United States population. It is also unclear whether other risk factors for pancreatitis are the underlying determinants of pancreatitis development in patients with CD.

The study authors obtained de-identified patient data from a commercial US national database (Explorys) that included 27 US health care networks from 1999 to the present. A total of 133,640 patients met the investigators’ criteria for CD.

“Active” cases included patients who were diagnosed with CD and then, any type of pancreatitis. “Control” cases constituted patients who were diagnosed with pancreatitis after their respective index visits, but not with CD. Individuals who previously received a CD diagnosis were excluded from the analysis.


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The prevalence of risk factors for pancreatitis was found to be two-to-three times higher in the CD cohort, according to the study authors. Specifically, the risk for receiving a pancreatitis diagnosis was 1.11% in patients with CD compared with 0.52% in patients who did not have CD (control cases). Patients with CD had a 2.16 times higher odds of receiving a subsequent pancreatitis diagnosis.

In a subgroup analysis, acute pancreatitis was 2.84 times (95% CI, 2.50-3.22) more likely to present in patients with CD vs chronic pancreatitis. When the investigators excluded patients with known pancreatitis risk factors from the analysis, the risk for developing subsequent pancreatitis (odds ratio [OR], 2.67; 95% CI, 2.17-3.28) or for presenting with acute vs chronic disease (OR, 3.06; 95% CI, 2.0-4.63) remained elevated.

“This study suggests that individuals with CD are at increased risk of pancreatitis. This risk appears to be due to CD itself as other risk factors for pancreatitis did not alter this finding,” the study authors concluded. “Patients with celiac disease should be counseled as to this risk and [advised] to avoid the known risk factors for the development of pancreatitis.”

Disclosure: One study author declared affiliations with the pharmaceutical industry. Please see the original reference for the author’s disclosures.

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Reference

Dahash BA, Alaber OA, Sankararaman S, Crespo SM, Sferra TJ. Association of celiac disease and pancreatitis – a national database study. Presented at: American College of Gastroenterology Annual Scientific Meeting; October 26-28, 2020. Abstract S0129