Machine learning prediction of pancreatitis risk with antithyroid drugs: a nationwide retrospective observational study

In recent years, there has been increasing data showing that the risk of acute pancreatitis (AP) is increased in patients using methimazole (MMI). The aim of this population-based study was to investigate the association between drugs used in the treatment of hyperthyroidism (MMI, PTU, propranolol) and the diagnosis of AP. The database consisted of more than 85 million citizen records between January 1, 2017 and December 31, 2022. Within the scope of the study, the data were examined of patients diagnosed with hyperthyroidism and the individuals who developed acute pancreatitis after being diagnosed with hyperthyroidism, which was accomplished using the International Classification of Diseases-10 (ICD-10) codes. Analyses were carried out using R Studio 4.2.0 software. The test-train technique as a machine learning method was used in cox regression models. A total of 1,329,934 individuals diagnosed with hyperthyroidism were examined. Of these, 10,815 (0.81%) patients developed acute pancreatitis after being diagnosed with hyperthyroidism. The use of propylthiouracil was determined to increase the probability of experiencing AP diagnosis 0.10-fold (10%) (p:0.0009), and the use of propranolol decrease the probability of experiencing AP 0.5-fold (5%) (p:0.032), with a 52.2% predictive success rate. There is no any statistically significant association between MMI use and the probability of experiencing AP according to the model have been build. Although the risk of experiencing AP was not increased by MMI use, PTU use increased and propronolol use decrease the risk of experiencing AP in patients with hyperthyroidism. Although drug-induced acute pancreatitis is relatively rare, a firm understanding of the drugs associated with the condition should alert the clinician to appropriately diagnose and treat patients.