Digoxin use may increase the relative risk of acute pancreatitis: A population-based case-control study in Taiwan

Objectives: The goal of this study was to evaluate the association between digoxin use and acute pancreatitis in Taiwan. Methods: Utilizing the database of the Taiwan National Health Insurance Program, this case-control study consisted of 6116 subjects aged 20-84 years with a first-attack of acute pancreatitis since 2000 to 2011 as the cases and 24,464 randomly selected subjects without acute pancreatitis as the controls. Both cases and controls were matched by sex, age and index year of diagnosing acute pancreatitis. The absence of digoxin prescription was defined as "never use". Active use of digoxin was defined as subjects who at least received 1 prescription for digoxin within 7 days before the date of diagnosing acute pancreatitis. Non-active use of digoxinwas defined as subjects who did not receive a prescription within 7 days but at least received 1 prescription for digoxin >= 8 days before the date of diagnosing acute pancreatitis. The odds ratio (OR) and 95% confidence interval (CI) were measured to evaluate the association between digoxin use and acute pancreatitis by a multivariable unconditional logistic regression model. Results: After adjusting for potential confounding factors, the adjusted OR of acute pancreatitis was 5.29 for subjects with active use of digoxin (95% CI 3.61, 7.73), when compared with subjects with never use of digoxin. The adjusted OR of acute pancreatitis decreased to 1.04 for subjectswith non-active use of digoxin (95% CI 0.89, 1.21), but no statistical significance. Conclusions: These data indicate that only persons actively using digoxin may have the high relative odds of acute pancreatitis. Further research or case report is warranted to evaluate the pathophysiological basis underlying the relationship between digoxin use and acute pancreatitis. (C) 2014 Elsevier Ireland Ltd. All rights reserved.