Pancreatic Enzyme Use Reduces Pancreatitis Frequency in Children with Acute Recurrent or Chronic Pancreatitis: A report from INSPPIRE

A Jay Freeman; Kenneth Ng; Fuchenchu Wang; Maisam A Abu-El-Haija; Ankur Chugh; Gretchen A Cress; Douglas S Fishman; Cheryl E Gariepy; Matthew J Giefer; Praveen Goday; Tanja Y Gonska; Amit S Grover; Douglas Lindblad; Quin Y Liu; Asim Maqbool; Jacob A Mark; Brian A McFerron; Megha S Mehta; Veronique D Morinville; Robert A Noel; Chee Y Ooi; Emily R Perito; Sarah Jane Schwarzenberg; Zachary M Sellers; Michael Wilschanski; Yuhua Zheng; Ying Yuan; Dana K Andersen; Mark E Lowe; Aliye Uc; Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC)

doi:10.14309/ajg.0000000000002772

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Pancreatic Enzyme Use Reduces Pancreatitis Frequency in Children with Acute Recurrent or Chronic Pancreatitis: A report from INSPPIRE

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Pancreatic Enzyme Use Reduces Pancreatitis Frequency in Children with Acute Recurrent or Chronic Pancreatitis: A report from INSPPIRE

A Jay Freeman, Kenneth Ng, Fuchenchu Wang, Maisam A Abu-El-Haija, Ankur Chugh, Gretchen A Cress, Douglas S Fishman, Cheryl E Gariepy, Matthew J Giefer, Praveen Goday, …

The American journal of gastroenterology, Vol.119(10), pp.2094-2102

10/2024

DOI: 10.14309/ajg.0000000000002772

PMCID: PMC11452285

PMID: 38517077

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https://pmc.ncbi.nlm.nih.gov/articles/PMC11452285/pdf/nihms-1978961.pdfView

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Abstract

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. Children with pancreatic sufficient ARP or CP in the INSPPIRE-2 cohort were included. Clinical outcomes were compared for those receiving versus 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. 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 to 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). 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.

Details

Title: Subtitle: Pancreatic Enzyme Use Reduces Pancreatitis Frequency in Children with Acute Recurrent or Chronic Pancreatitis: A report from INSPPIRE
Creators: A Jay Freeman - The Ohio State University
Kenneth Ng - Johns Hopkins University School of Medicine
Fuchenchu Wang - The University of Texas MD Anderson Cancer Center
Maisam A Abu-El-Haija - University of Cincinnati
Ankur Chugh - Medical College of Wisconsin
Gretchen A Cress - University of Iowa
Douglas S Fishman - Baylor College of Medicine
Cheryl E Gariepy - The Ohio State University
Matthew J Giefer - Ochsner Medical Center
Praveen Goday - The Ohio State University
Tanja Y Gonska - Hospital for Sick Children
Amit S Grover - Boston Children's Hospital
Douglas Lindblad - University of Pittsburgh Medical Center
Quin Y Liu - Cedars-Sinai Medical Center
Asim Maqbool - Children's Hospital of Philadelphia
Jacob A Mark - Children's Hospital Colorado
Brian A McFerron - Indiana University
Megha S Mehta - The University of Texas Southwestern Medical Center
Veronique D Morinville - McGill University
Robert A Noel - Baylor College of Medicine
Chee Y Ooi - UNSW Sydney
Emily R Perito - University of California, San Francisco
Sarah Jane Schwarzenberg - University of Minnesota
Zachary M Sellers - Stanford University
Michael Wilschanski - Hadassah Medical Center
Yuhua Zheng - Children's Hospital of Los Angeles
Ying Yuan - The University of Texas MD Anderson Cancer Center
Dana K Andersen - National Institutes of Health
Mark E Lowe - Washington University in St. Louis
Aliye Uc - University of Iowa
Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC)
Resource Type: Journal article
Publication Details: The American journal of gastroenterology, Vol.119(10), pp.2094-2102
DOI: 10.14309/ajg.0000000000002772
PMID: 38517077
PMCID: PMC11452285
NLM abbreviation: Am J Gastroenterol
eISSN: 1572-0241
Grant note: U01DK108334 / Division of Diabetes, Endocrinology, and Metabolic Diseases U01DK108328 / Division of Diabetes, Endocrinology, and Metabolic Diseases
Language: English
Electronic publication date: 03/22/2024
Date published: 10/2024
Academic Unit: Stead Family Department of Pediatrics; Radiation Oncology; Gastroenterology, Hepatology, Pancreatology, and Nutrition
Record Identifier: 9984573758502771

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