Clinical Outcomes in Alcohol-Related vs Non-Alcohol-Related Chronic Pancreatitis

A new study published in the journal of Gastroenterology Research showed that alcohol-related chronic pancreatitis (ARCP) is linked to reduced mortality, diabetes, and exocrine pancreatic insufficiency when compared to non-alcohol-related chronic pancreatitis (NARCP).

Through toxic, oxidative, and inflammatory processes, alcohol use disorder has historically been a primary cause of ARCP. On the other hand, genetic, autoimmune, obstructive, recurring acute pancreatitis, and idiopathic causes are included in NARCP. There is growing evidence that the prognosis, comorbidities, and course of the disease are different for ARCP and NARCP.

While NARCP has varied symptoms and delayed development, especially in younger individuals, ARCP frequently exhibits fast structural and functional alterations with a higher comorbidity load. Thus, this study was carried out to evaluate real-world clinical outcomes between alcohol-related and non-alcohol-related chronic pancreatitis.

Using the TriNetX US Collaborative Network, this research performed a retrospective cohort research to examine the baseline features and clinical results of ARCP and NARCP. The two cohorts' baseline characteristics were balanced using propensity score matching (PSM). Exocrine pancreatic insufficiency (EPI), pseudocyst formation, the onset of diabetes and pancreatic cancer, and the requirement for endoscopic retrograde cholangiopancreatography (ERCP) and celiac plexus injection were among the secondary events.

A total of 203,432 CP patients were found, comprising 200,560 NARCP and 11,696 ARCP. ARCP was linked to significantly lower rates of death (13.0% vs. 16.2%; risk ratio (RR) 0.80), diabetes (22.9% vs. 35.8%; RR 0.64), exocrine pancreatic insufficiency (2.0% vs. 6.1%; RR 0.32), pancreatic cancer (1.1% vs. 8.4%; RR 0.14), and pseudocyst formation (7.1% vs. 9.7%; RR 0.73) in comparison to NARCP (all P < 0.001).

Also, celiac plexus injection (0.1% vs. 0.8%; RR 0.12) and ERCP (2.3% vs. 10.2%; RR 0.23) rates were lower in ARCP patients (both P < 0.001). Overall, this study emphasizes the need of etiology-based treatment approaches by highlighting notable disparities in the therapeutic requirements and clinical outcomes of individuals with ARCP and NARCP.

Patients with alcohol-related diseases had lower rates of death, complications, and interventions than patients with non-alcohol-related diseases. These findings offer valuable insights into disease patterns that may impact prognosis and direct treatment choices. To build on these results and investigate precision medicine strategies specific to each CP subtype, more prospective research is necessary.

Source:

Elfert, K., Abusuliman, M., Eldesouki, M., Ahmed, O. T., Abosheaishaa, H., Beran, A., Mohamed, M., Nassar, M., Singh, S., & Elhanafi, S. (2025). The impact of chronic pancreatitis etiology on clinical outcomes: A population-based propensity-matched analysis. Gastroenterology Research, 18(6), 269–275. https://doi.org/10.14740/gr2050