Postmenopausal HRT associated with higher acute pancreatitis risk, study finds

Postmenopausal women taking hormone replacement therapy (HRT) may be at higher risk for acute pancreatitis, according to a new study.

Researchers performed a prospective study of postmenopausal women who participated in the Swedish Mammography Cohort. All women took a baseline questionnaire in 1997 that asked about HRT use. The study cohort was compared with the Swedish National Patient Register to assess hospital admissions due to acute pancreatitis through 2010. The study results were published online by CMAJ on Jan. 27.

A total of 31,494 women ranging in age from 48 to 83 years were included in the study. Total follow-up was 389,456 person-years, and in that time, 237 cases of incident acute pancreatitis were identified. Forty-two percent of women used HRT at baseline and 12% had used it in the past. Among those who were currently taking HRT at baseline, 6,795 (52%) were taking systemic therapy, 4,148 (32%) were using local therapy and 2,170 (17%) were using both. Age-standardized incidence rates of acute pancreatitis were 71 cases per 100,000 person-years in women who had ever used HRT and 52 cases per 100,000 person-years in those who had never done so. The multivariable-adjusted relative risk among ever users was 1.57 (95% CI, 1.20 to 2.05) versus never users. The researchers did not find a difference in risk between current and past use, but women who took systemic therapy and those who took HRT for over 10 years appeared to have higher risk (relative risks, 1.92 [95% CI, 1.38 to 2.66] and 1.87 [95% CI, 1.11 to 3.17], respectively).

The authors acknowledged that their study relied on self-reported information on HRT and that information on the type of HRT used was lacking, among other limitations. However, based on their results, they concluded that postmenopausal HRT is associated with a higher risk for acute pancreatitis in this population and that more research, including research on the role of HRT preparation, dose and route of administration, is needed. “If these findings are confirmed by other studies, the risk of acute pancreatitis should be considered when hormone replacement therapy is prescribed,” they wrote.