Early Clinical Experience with Simvastatin for Treating Pain in Patients with Idiopathic Chronic Pancreatitis
Published: August 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/42065.13046
Rajiv Mehta, Mayank Kabrawala, Subhash Nandwani, Pankaj Desai, Parika Kalra, Ritesh Prajapati, Prachi Joshi
1. Consultant Gastroenterologist, Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, India.
2. Consultant Gastroenterologist, Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, India.
3. Consultant Gastroenterologist, Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, India.
4. GI Endoscopist, Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, India.
5. Consultant Gastroenterologist, Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, India.
6. Consultant Gastroenterologist, Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, India.
7. Research Associate, Department of Clinical Research, Surat Institute of Digestive Sciences (SIDS), Surat, Gujarat, India.
Correspondence
Dr. Rajiv Mehta,
Consultant Gastroenterologist, Department of Gastroenterology, Surat Institute of Digestive Sciences (SIDS),
Surat-395002, Gujarat, India.
E-mail: rmgastro@yahoo.com
Introduction: Chronic Pancreatitis (CP) is a progressive inflammatory disorder characterised by recurrent episodes of severe abdominal pain. Experimental studies demonstrated protective effects of statins in pancreatic fibrosis.
Aim: To assess impact of simvastatin therapy on the severity of pain in patients with idiopathic CP or recurrent acute pancreatitis.
Materials and Methods: This prospective, single centre and open-label study included patients with idiopathic CP and recurrent acute pancreatitis, depending upon inclusion and exclusion criteria. Patients were treated with either simvastatin (40 mg per day) (Group-A; n=25) or standard therapy (proton-pump inhibitor and antioxidant therapy) (Group-B; n=25). Severity of the pain was assessed using a Visual Analogue Score (VAS) at the start of treatment and at 12-month of treatment.
Results: Between June 2017 and August 2017, a total of 50 patients, age ranging from 18 years to 54 years, were included in the study. The study population predominantly included male patients (n=38). The intensity of pain in patients of Group-A reduced significantly (p=0.0001) from 8 (range 6-10) at baseline to 2 (range 0-9) after 12 months of the treatment. There was significant reduction in the intensity of pain in Group-B also {7 (range 6-10) at baseline vs. 5 (range 0-7); p=0.0001}. However, the reduction of VAS score was significantly higher in Group-A as compared to Group-B at 12-month follow-up {6 (range-1-8) vs. 3 (range 0-6); p=0.032}.
Conclusion: Simvastatin treatment improved severity of pain in patients with CP or recurrent acute pancreatitis at 12-month follow-up. However, large randomised trials are needed to replicate these findings.
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