Use of pancreatic endotherapy in patients with chronic pancreatitis: results from a multicenter cohort study in the United States.

Background and Aims: Although pancreatic endotherapy (PET) is commonly used for treating adverse events of chronic pancreatitis, data on the frequency and factors associated with the use of PET are limited. Our aim was to define the use of and factors predictive for receiving PET in a well-characterized chronic pancreatitis cohort.
Methods: This is a cross-sectional analysis of data from PROCEED, a multicenter U.S. cohort study of chronic pancreatitis. PET modalities primarily consisted of ERCP. A treatment course was defined as the number of sessions performed for a specific indication. A repeat course was defined as PET >1 year after completion of the last course. Multivariable logistic regression identified predictive factors for receiving PET, and proportional rates model assessed risk factors for repeat PET.
Results: Of 681 subjects, 238 (34.9%) received PET. Factors associated with receiving PET included female sex (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.03-1.53), lower education (OR, 1.30; 95% CI, 1.04-1.62), income ≤$50,000 per year (OR, 1.35; 95% CI, 1.07-1.71), and prior acute pancreatitis (OR, 1.74; 95% CI, 1.31-2.32). Of 238 subjects, 103 (43.3%) underwent repeat PET at a median duration of 2 years, with 23.1% receiving 2 courses, 9.7% receiving 3 courses, and 10.4% receiving ≥4 courses.
Conclusions: Nearly half of patients with chronic pancreatitis who undergo PET received 1 or more repeat courses within 2 to 3 years. In addition to a prior history of acute pancreatitis, demographic and socioeconomic factors were associated with receiving PET.
Competing Interests: Disclosure The following authors disclosed financial relationships: S. Han, J. J. Easler: Consultant for Boston Scientific. W. G. Park: Research support from AbbVie; advisory board for Nestle, Pfizer, and Ariel Medicine; consultant for Arctx Medical, Olympus, and Capsovision. S. S. Vege: Royalties from UpToDate. D. Yadav: Research support from AbbVie; consultant for Pfizer. All other authors disclosed no financial relationships. Research support for this study was provided by the National Cancer Institute and National Institute of Diabetes and Digestive and Kidney Diseases under award numbers U01DK108288 (Mayo Clinic), U01DK108320 (University of Florida), U01DK108323 (Indiana University), U01DK108326 (Baylor College of Medicine), U01DK108327 (The Ohio State University), U01DK108300 (Stanford University), U01DK108306 (University of Pittsburgh), U01DK108314 (Cedars-Sinai Medical Center), U01DK108328 (University of Texas–MD Anderson Cancer Center), and U01DK108332 (Kaiser Foundation Research Institute).
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