Simvastatin in Reducing Pancreatitis in Patients With Recurrent, Acute or Chronic Pancreatitis

Inclusion Criteria

• •At least two episodes of acute pancreatitis in the past 12 months; acute pancreatitis is defined any 2 of the following: (1) typical upper abdominal pain; (2) elevation in serum amylase or lipase \>= 3 times upper limit of normal; (3) features of acute pancreatitis on cross-sectional imaging
• •Eastern Cooperative Oncology Group (ECOG) performance status =\< 1 (Karnofsky \>= 70%)
• •Leukocytes \>= 2,500/microliter
• •Absolute neutrophil count \>= 1,500/microliter
• •Platelets \>= 100,000/microliter
• •Hemoglobin \> 10 g/dL
• •Total bilirubin =\< 3.0 x institutional upper limit of normal (ULN)
• •Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 1.5 x institutional ULN; patients whose AST/ALT levels normalize by screen 2 after an abnormal test will be included in the trial
• •Creatinine \< 1.5 mg/dL
• •Women of child-bearing potential must have a confirmed negative pregnancy test result prior to enrollment
• •The effects of simvastatin on the developing human fetus at the recommended therapeutic dose are unknown; for this reason and because statins are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her study physician immediately; it is not known whether simvastatin is excreted into human milk; however, a small amount of another drug in this class does pass into breast milk; because statins have the potential for serious adverse reactions in nursing infants, women who receive treatment with simvastatin should not breastfeed their infants
• •Ability to understand and the willingness to sign a written informed consent document and medical release
• •Willing and able to comply with trial protocol and follow-up
• •Recurrent pancreatitis episode is iatrogenic (endoscopic retrograde cholangiopancreatography \[ERCP\] induced)
• •Advanced chronic pancreatitis as determined by the following criteria: EUS score greater than 6, calcifications in combination with atrophy and/or dilation of \>= 5 mm, or evidence of advanced chronic pancreatitis by computed tomography (CT) or magnetic resonance imaging (MRI) results in the past 12 months