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Putting to rest concerns raised by previous research, this new study finds cholesterol-lowering drugs such as Lipitor (atorvastatin) and Zocor (simvastatin) may actually help ward off pancreatitis. The pooled analysis of 21 published and unpublished randomized, controlled trials -- the gold standard of medical research -- found that people taking statins were at 18 percent to 23 percent reduced chance of developing pancreatitis.
Researchers also looked at a class of drugs called fibrates, which doctors prescribe for people with high triglycerides, another type of blood fat. Their analysis found a slight, but statistically insignificant, increase of developing pancreatitis from fibrates.
"Statins seem to carry a previously unrecognized benefit of reducing pancreatitis risk, which actually contradicts what was previously reported in the literature," said senior study author Dr. David Preiss, a physician at the University of Glasgow in Scotland.
The study is published in the Aug. 22/29 issue of the Journal of the American Medical Association.
The pancreas, an organ located behind the stomach, makes digestive enzymes and hormones including insulin.
Prior studies have suggested that statins may increase the risk of pancreatitis, but the new review of data from trials that included more than 150,000 participants found no such connection.
"This data give us confidence we don't need to worry about pancreatitis occurring from statin drugs," said Dr. Robert Eckel, past president of the American Heart Association and a professor of medicine at University of Colorado, in Denver.
Statins work by reducing LDL ("bad") cholesterol, and studies have shown this reduces heart attacks and strokes, he added.
The story with fibrates is more complicated. Fibrates help to reduce triglycerides, an unhealthy blood fat, while boosting HDL ("good") cholesterol. But studies on whether reducing levels of triglycerides using fibrates leads to a reduction in heart attacks and stroke have been mixed, experts said.
And very high triglyceride levels on their own are a risk factor for pancreatitis.
In the review, researchers examined data from seven randomized clinical trials of fibrates that included data on more than 40,000 participants. Patients, who were followed on average for more than five years, had slightly elevated triglyceride levels -- between 145 mg/dL to 184 mg/dL. (Normal is below 150 mg/dL, Eckel said.)
Among those patients, the analysis showed a slightly increased chance of developing pancreatitis while on fibrates, but it wasn't statistically significant.
Based on that finding, the authors said statins appear to be better than fibrates at preventing pancreatitis in people with slightly elevated triglyceride levels.
What's not covered in this review is what effect fibrates would have on people with higher triglycerides. Typically, when Eckel sees patients with very high triglyceride levels (above 1,000 mg/dL), he first puts them on a low-fat diet to bring down the levels to the 500 to 1,000 mg/dL range before prescribing fibrates.
"The fibrate trials gives us a hint that maybe there was a relationship between the fibrates and pancreatitis, but that wouldn't keep us from using fibrates to treat high triglycerides," Eckel said.
Overall, whether they were taking statins, fibrates or placebo, the number of people who developed pancreatitis in the trials was small -- less than 1 percent.
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