Tamoxifen use in breast cancer not linked to acute pancreatitis
The use of tamoxifen in breast cancer patients is not associated with the incidence of acute pancreatitis (AP), a new study shows.
The population-based cohort study used data from the National Health Insurance Research Database of Taiwan. New-onset breast cancer patients at least 20 years of age were included. Those with histories of pancreatic cancer and acute and chronic pancreatitis were excluded.
The accumulated defined daily dose (DDD) of tamoxifen prescribed during the follow-up periodwas calculated. Prescription information was calculated yearly after the index date to account for changes in drug use over time.
Before propensity score matching, 22,005 patients (mean age53.4 years)did not receive tamoxifen while 40,484 did (mean age 51.4 years). Asthma (p=0.01) and hyperlipidaemia (p<0.001) were more common in nonusers while fluorouracil use was more common in tamoxifen users (p<0.001). Differences disappeared after propensity score matching.
Alcohol-related diseases (adjusted hazard ratio [aHR], 1.56; 95 percent CI, 0.50 to 4.88), despite being known to cause chronic and acute pancreatitis, were not associated with AP after controlling for age. Similarly, hepatitis B (aHR, 1.15; 0.62 to 2.10) and hepatitis C (aHR, 1.28; 0.63 to 2.61) virus infections were also not associated with AP.
On the other hand, diabetes mellitus (aHR, 1.63; 1.23 to 2.61) and gallstones (aHR, 3.19; 2.33 to 4.35) correlated with an increased risk of AP after controlling for age.
After adjustment for age, comorbidities and medications, the risk of AP was not significant between tamoxifen users and nonusers (aHR, 0.94; 0.74 to 1.19) in the nonmatching cohorts. No dose–response trend existed between tamoxifen use and the risk of AP (aHR, 0.98; 0.96 to 1.00).