PEDIATRIC DRUG-ASSOCIATED PANCREATITIS REVEALS CONCOMITANT RISK FACTORS AND POOR RELIABILITY OF CAUSALITY SCORING: REPORT FROM INSPPIRE

Veronique D Morinville; Sohail Z Husain; Fuchenchu Wang; Gretchen A Cress; Maisam Abu-El-Haija; Ankur Chugh; Elissa Downs; Kate Ellery; Douglas S Fishman; Alvin Jay Freeman; Cheryl E Gariepy; Matthew Giefer; Tanja Gonska; Quin Liu; Asim Maqbool; Jacob Mark; Brian Arthur Mcferron; Megha Mehta; Jaimie D Nathan; Ken Ng; Chee Y Ooi; Emily Perito; Wenly Ruan; Sarah Jane Schwarzenberg; Zachary M Sellers; Jose Serrano; David M Troendle; Michael Wilschanski; Yuhua Zheng; Ying Yuan; Mark Lowe; Aliye Uc

doi:10.1097/MPG.0000000000003898

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PEDIATRIC DRUG-ASSOCIATED PANCREATITIS REVEALS CONCOMITANT RISK FACTORS AND POOR RELIABILITY OF CAUSALITY SCORING: REPORT FROM INSPPIRE

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PEDIATRIC DRUG-ASSOCIATED PANCREATITIS REVEALS CONCOMITANT RISK FACTORS AND POOR RELIABILITY OF CAUSALITY SCORING: REPORT FROM INSPPIRE

Veronique D Morinville, Sohail Z Husain, Fuchenchu Wang, Gretchen A Cress, Maisam Abu-El-Haija, Ankur Chugh, Elissa Downs, Kate Ellery, Douglas S Fishman, Alvin Jay Freeman, …

Journal of pediatric gastroenterology and nutrition, Vol.77(4), pp.540-546

10/2023

DOI: 10.1097/MPG.0000000000003898

PMCID: PMC10529270

PMID: 37496124

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Abstract

Objectives: Drug-associated acute pancreatitis (DAP) studies typically focus on single acute pancreatitis (AP) cases. We aimed to analyze the (1) characteristics, (2) co-risk factors, and (3) reliability of the Naranjo scoring system for DAP using INSPPIRE-2 (the INternational Study group of Pediatric Pancreatitis: In search for a cuRE-2) cohort study of acute recurrent (ARP) and chronic pancreatitis (CP) in children. Methods: Data were obtained from ARP group with ≥1 episode of DAP and CP group with medication exposure +/- DAP. Physicians could report multiple risk factors. Pancreatitis associated with Medication (Med) (ARP+CP) was compared to Non-Medication cases, and ARP-Med vs CP-Med groups. Naranjo score was calculated for each DAP episode. Results: Of 726 children, 392 had ARP, 334 CP. 51 children (39 ARP and 12 CP) had ≥ 1 AP associated with a medication. 61% had ≥ 1 AP without concurrent medication exposure. The Med group had other risk factors present (where tested): 10/35 (28.6%) genetic, 1/48 (2.1%) autoimmune pancreatitis, 13/51 (25.5%) immune-mediated conditions, 11/50 (22.0%) obstructive/ anatomic, 28/51 (54.9%) systemic risk factors. In Med group, 24/ 51 (47%) had involvement of >1 medication, simultaneously or over different AP episodes. There were 20 ARP and 4 CP cases in “probable” category and 19 ARP and 7 CP in “possible” category by Naranjo scores. Conclusions: Medications were involved in 51/ 726 (7%) of ARP or CP patients in INSPPIRE-2 cohort; other pancreatitis risk factors were present in most, suggesting a potential additive role of different risks. The Naranjo scoring system failed to identify any cases as “definitive”, raising questions about its reliability for DAP.

Details

Title: Subtitle: PEDIATRIC DRUG-ASSOCIATED PANCREATITIS REVEALS CONCOMITANT RISK FACTORS AND POOR RELIABILITY OF CAUSALITY SCORING: REPORT FROM INSPPIRE
Creators: Veronique D Morinville - Montreal Children's Hospital
Sohail Z Husain - Stanford University
Fuchenchu Wang - The University of Texas MD Anderson Cancer Center
Gretchen A Cress - University of Iowa Stead Family Children’s Hospital
Maisam Abu-El-Haija - Cincinnati Children's Hospital Medical Center
Ankur Chugh - Medical College of Wisconsin
Elissa Downs - University of Minnesota Children's Hospital
Kate Ellery - Children's Hospital of Pittsburgh
Douglas S Fishman - Baylor College of Medicine
Alvin Jay Freeman - Nationwide Children's Hospital
Cheryl E Gariepy - Nationwide Children's Hospital
Matthew Giefer - Ochsner Medical Center
Tanja Gonska - Hospital for Sick Children
Quin Liu - Cedars-Sinai Medical Center
Asim Maqbool - Children's Hospital of Philadelphia
Jacob Mark - Children's Hospital Colorado
Brian Arthur Mcferron - Riley Hospital for Children
Megha Mehta - The University of Texas Southwestern Medical Center
Jaimie D Nathan - Nationwide Children's Hospital
Ken Ng
Chee Y Ooi - Sydney Children's Hospital
Emily Perito - University of California San Francisco Medical Center
Wenly Ruan - Texas Children's Hospital
Sarah Jane Schwarzenberg - University of Minnesota Children's Hospital
Zachary M Sellers - Palo Alto University
Jose Serrano - National Institute of Diabetes and Digestive and Kidney Diseases
David M Troendle - The University of Texas Southwestern Medical Center
Michael Wilschanski
Yuhua Zheng
Ying Yuan - The University of Texas MD Anderson Cancer Center
Mark Lowe - Washington University in St. Louis
Aliye Uc - University of Iowa
Resource Type: Journal article
Publication Details: Journal of pediatric gastroenterology and nutrition, Vol.77(4), pp.540-546
DOI: 10.1097/MPG.0000000000003898
PMID: 37496124
PMCID: PMC10529270
NLM abbreviation: J Pediatr Gastroenterol Nutr
eISSN: 1536-4801
Language: English
Electronic publication date: 07/27/2023
Date published: 10/2023
Academic Unit: Stead Family Department of Pediatrics; Radiation Oncology; Gastroenterology, Hepatology, Pancreatology, and Nutrition
Record Identifier: 9984447959502771

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