Pancreatic enzyme replacement therapy may cut risk of acute Pancreatitis in kids with acute recurrent pancreatitis: Study

A recent study discovered that pancreatic enzyme replacement therapy (PERT) may significantly reduce the frequency of acute pancreatitis (AP) episodes in children who were diagnosed with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP) and still have sufficient pancreatic function. The findings of this study published in the American Journal of Gastroenterology offer new hope for managing the painful episodes and high hospitalization rates.

Acute pancreatitis represents a major challenge in pediatric gastroenterology due to its debilitating pain and potential to progress into chronic illness that necessitates frequent hospital interventions. Traditionally, no preventative treatments for AP episodes have been available by making the management of ARP and CP particularly difficult.

The study encompassed a total of 356 children who retained adequate pancreatic function with a significant majority, 270 participants suffered from ARP. Only 60 children received PERT as part of their treatment regimen. The study noted that after starting PERT, 42% of these children did not experience further AP episodes during the average follow-up period of 2.1 years.

The findings of this research unveils the effectiveness of PERT in reducing the annual incidence rate of AP episodes. Before initiating PERT, the mean annual rate of AP episodes stood at 3.14 per patient. This rate dramatically decreased to just 0.71 after the treatment by marking a significant improvement in managing the condition.

Genetic factors also played a role in the success of this therapy. The outcomes highlighted that children with a SPINK1 gene mutation and those who were diagnosed with ARP showed a reduced likelihood of experiencing AP episodes post-PERT initiation. This genetic insight points to a potential tailored approach in treating pancreatitis based on individual genetic profiles.

These results strongly support the initiation of a clinical trial to verify the efficacy of PERT in enhancing the clinical outcomes for children with these pancreatic conditions. The study advocates for such trials to answer the need of establishing concrete evidence to integrate PERT into standard treatment protocols. 

Reference:

Freeman, A. J., Ng, K., Wang, F., Abu-El-Haija, M. A., Chugh, A., Cress, G. A., Fishman, D. S., Gariepy, C. E., Giefer, M. J., Goday, P., Gonska, T. Y., Grover, A. S., Lindblad, D., Liu, Q. Y., Maqbool, A., Mark, J. A., McFerron, B. A., Mehta, M. S., … Morinville, V. D. (2024). Pancreatic Enzyme Use Reduces Pancreatitis Frequency in Children With Acute Recurrent or Chronic Pancreatitis: A Report From INSPPIRE. In American Journal of Gastroenterology. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.14309/ajg.0000000000002772