A0011 - Increased Risk of Pancreatitis, Pancreatic Cancer, and Mortality in Patients With Celiac Disease

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

AK

Arukumar Krishnan, MBBS

West Virginia University School of Medicine
Morgantown, WV

Arukumar Krishnan, MBBS¹, Rushik Patel, ², Yousaf Hadi, MD¹, Shailendra Singh, MD¹, Shyam Thakkar, MD¹
¹West Virginia University School of Medicine, Morgantown, WV; ²West Virginia University, Morgantown, WV

Introduction: Celiac disease (CD) is an immune-mediated enteropathy associated with inflammation precipitated by dietary gluten in genetically predisposed individuals. Few studies reported a higher incidence of pancreatitis in the CD population. It is unclear whether this risk has changed in the era of more comprehensive diagnosis rates and less severe clinical disease. Using a large database, we sought to evaluate the association between CD and acute pancreatitis (AP), chronic pancreatitis (CP), and pancreatic cancer(PC) risk at a population level.

Methods: This multicenter, retrospective cohort study was conducted using the TriNetX platform. All adult patients ( >18 years) diagnosed with CD were identified based on ICD-10 codes between March 2005 and April 2022. The primary outcome was the occurrence of AP and CP in CD patients. Secondary outcomes were the incidence of PC and mortality. Any patients with a history of pancreatic disease events before March 2005 were excluded. Data were matched with individuals without CD during the same period. We performed a 1:1 propensity score matching (PSM) for demographics, smoking, alcohol-related disease, diabetes, hyperlipidemia, and comorbid conditions. The risk ratio (RR) was calculated to compare the association between CD and the outcome

Results: A total of 479,020 patients were analyzed, and there were 162,362 patients with CD. After PSM, there were 142,902 patients with CD or without CD. The mean age of patients was 41.7 years, with 70.7% women and 78% White. Patients in the CD group had a higher prevalence of comorbidities such as diabetes and hypercholesterolemia than those without CD. The incidence of AP and CP after 3 years of CD diagnosis was 0.19% and 0.39%, respectively; PC and mortality were 0.04% and 1.16% compared to non-CD patients. Individuals with CD had a higher risk of AP (RR 1.30; 95% CI 1.08-1.56), CP(1.57; 95% CI 1.37-1.80), PC(1.48; 1.01-2.16) and mortality (RR 1.36; 95% CI 1.26-1.46) than non-CD patients (Table 1)

Discussion: This population-based multicenter study suggests that individuals with CD are at increased risk of pancreatitis, PC, and mortality

Outcomes	With CD		Without CD		Outcomes
Outcomes	Number of patients	Patients with the outcome, n(%)	Number of patients	Patients with outcome, n(%)	Risk ratio (95% CI)
Primary outcomes
Acute Pancreatitis	140528	268(0.19)	138467	202(0.14)	1.30(1.08-1.56)
Chronic Pancreatitis	136924	546(0.39)	136212	345(0.25)	1.57(1.37-1.80)
Etiology of Pancreatitis
Biliary Pancreatitis	142670	48(0.03)	142599	25(0.01)	1.91(1.18-3.11)
Idiopathic Pancreatitis	142744	45(0.03)	142651	28(0.01)	1.60(1.00-2.57)
Alcohol Pancreatitis	142752	28(0.02)	142724	10(0.01)	2.79(1.36-5.76)
Secondary outcomes
Pancreatic cancer	142583	67(0.04)	142148	45(0.03)	1.48(1.01-2.16)
Mortality	137778	1611(1.16)	136892	1194(0.85)	1.36(1.26-5.76)
Abbreviations: CD, celiac disease; CI, confidence interval.

Table: Table 1: Incidence of Pancreatitis, Pancreatic Cancer, and Mortality in patients with and without Celiac Disease after Propensity Matching at 3 years

Disclosures:

Arukumar Krishnan indicated no relevant financial relationships.

Rushik Patel indicated no relevant financial relationships.

Yousaf Hadi indicated no relevant financial relationships.

Shailendra Singh indicated no relevant financial relationships.

Shyam Thakkar indicated no relevant financial relationships.

Arukumar Krishnan, MBBS¹, Rushik Patel, ², Yousaf Hadi, MD¹, Shailendra Singh, MD¹, Shyam Thakkar, MD¹. A0011 - Increased Risk of Pancreatitis, Pancreatic Cancer, and Mortality in Patients With Celiac Disease, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.