TY - JOUR
T1 - Pancreatic Enzyme Use Reduces Pancreatitis Frequency in Children With Acute Recurrent or Chronic Pancreatitis
T2 - A Report From INSPPIRE
AU - Freeman, Alvin Jay
AU - Ng, Kenneth
AU - Wang, Fuchenchu
AU - Abu-El-Haija, Maisam A.
AU - Chugh, Ankur
AU - Cress, Gretchen A.
AU - Fishman, Douglas S.
AU - Gariepy, Cheryl E.
AU - Giefer, Matthew J.
AU - Goday, Praveen
AU - Gonska, Tanja Y.
AU - Grover, Amit S.
AU - Lindblad, Douglas
AU - Liu, Quin Y.
AU - Maqbool, Asim
AU - Mark, Jacob A.
AU - Mcferron, Brian A.
AU - Mehta, Megha S.
AU - Morinville, Veronique D.
AU - Noel, Robert A.
AU - Ooi, Chee Y.
AU - Perito, Emily R.
AU - Schwarzenberg, Sarah Jane
AU - Sellers, Zachary M.
AU - Wilschanski, Michael
AU - Zheng, Yuhua
AU - Yuan, Ying
AU - Andersen, Dana K.
AU - Lowe, Mark E.
AU - Uc, Aliye
N1 - Publisher Copyright:
© 2024 by The American College of Gastroenterology.
PY - 2024/10/1
Y1 - 2024/10/1
N2 - INTRODUCTION:Among children who suffer from acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP), acute pancreatitis (AP) episodes are painful, often require hospitalization, and contribute to disease complications and progression. Despite this recognition, there are currently no interventions to prevent AP episodes. In this retrospective cohort study, we assessed the impact of pancreatic enzyme therapy (PERT) use on clinical outcomes among children with pancreatic-sufficient ARP or CP.METHODS:Children with pancreatic-sufficient ARP or CP in the INSPPIRE-2 cohort were included. Clinical outcomes were compared for those receiving vs not receiving PERT, as well as frequency of AP before and after PERT. Logistic regression was used to study the association between development of AP episodes after starting PERT and response predictors.RESULTS:Among 356 pancreatic-sufficient participants, 270 (76%) had ARP, and 60 (17%) received PERT. Among those on PERT, 42% did not have a subsequent AP episode, during a mean 2.1 years of follow-up. Children with a SPINK1 mutation (P = 0.005) and those with ARP (compared with CP, P = 0.008) were less likely to have an AP episode after starting PERT. After initiation of PERT, the mean AP annual incidence rate decreased from 3.14 down to 0.71 (P < 0.001).DISCUSSION:In a retrospective analysis, use of PERT was associated with a reduction in the incidence rate of AP among children with pancreatic-sufficient ARP or CP. These results support the need for a clinical trial to evaluate the efficacy of PERT to improve clinical outcomes among children with ARP or CP.
AB - INTRODUCTION:Among children who suffer from acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP), acute pancreatitis (AP) episodes are painful, often require hospitalization, and contribute to disease complications and progression. Despite this recognition, there are currently no interventions to prevent AP episodes. In this retrospective cohort study, we assessed the impact of pancreatic enzyme therapy (PERT) use on clinical outcomes among children with pancreatic-sufficient ARP or CP.METHODS:Children with pancreatic-sufficient ARP or CP in the INSPPIRE-2 cohort were included. Clinical outcomes were compared for those receiving vs not receiving PERT, as well as frequency of AP before and after PERT. Logistic regression was used to study the association between development of AP episodes after starting PERT and response predictors.RESULTS:Among 356 pancreatic-sufficient participants, 270 (76%) had ARP, and 60 (17%) received PERT. Among those on PERT, 42% did not have a subsequent AP episode, during a mean 2.1 years of follow-up. Children with a SPINK1 mutation (P = 0.005) and those with ARP (compared with CP, P = 0.008) were less likely to have an AP episode after starting PERT. After initiation of PERT, the mean AP annual incidence rate decreased from 3.14 down to 0.71 (P < 0.001).DISCUSSION:In a retrospective analysis, use of PERT was associated with a reduction in the incidence rate of AP among children with pancreatic-sufficient ARP or CP. These results support the need for a clinical trial to evaluate the efficacy of PERT to improve clinical outcomes among children with ARP or CP.
KW - acute pancreatitis
KW - chronic pancreatitis
KW - pancreatic enzymes
KW - pediatrics
KW - PERT
UR - http://www.scopus.com/inward/record.url?scp=85203154946&partnerID=8YFLogxK
U2 - 10.14309/ajg.0000000000002772
DO - 10.14309/ajg.0000000000002772
M3 - Article
C2 - 38517077
AN - SCOPUS:85203154946
SN - 0002-9270
VL - 119
SP - 2094
EP - 2102
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 10
ER -