New Research Shows Impact, Efficacy of PERT in Pediatric Patients With Pancreatitis

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The authors believe that pancreatic enzyme therapy has potential in managing patient symptoms, altering the disease course, and the development of standardized care.

Health care worker with model of pancreas -- Image credit: Jo Panuwat D | stock.adobe.com

Image credit: Jo Panuwat D | stock.adobe.com

Findings from a study published in American Journal of Gastroenterology demonstrated that pancreatic enzyme therapy (PERT) helped reduce the frequency of acute pancreatitis (AP) in pediatric patients with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP). The findings show the potential PERT has in both managing symptoms and altering the course of the disease.1

The retrospective cohort study enrolled 356 pediatric patients with ARP in the INSPPIRE-2 cohort to determine the clinical outcomes of PERT. Investigators compared the efficacy and outcomes of patients who received PERT with those who did not, as well as the frequency of AP prior to and following PERT. Further, logistic regression was used to evaluate the association between development of AP episodes after the initiation of PERT and response predictors.1,2

Among the 356 participants enrolled in the study, 270 (76%) ARP and 60 (17%) received PERT. Following the initiation of PERT, the mean annual incidence rate had decreased from about 3.14 to about 0.71 (p < .001). In addition, the findings also indicated that approximately 42% of pediatric patients on PERT reported not experiencing any following AP episodes over an average follow-up period of 2.1 years. Further, patients who had a SPINK1 mutation (p = .005) and those with ARP, compared with CP, were less likely to have an AP episode following initiation of PERT.2

"Our findings not only highlight PERT's role in significantly reducing the incidence of acute pancreatitis episodes among children with recurrent or chronic pancreatitis but also underscore the importance of a tailored treatment approach based on genetic markers,” said study author Matthew Giefer, MD, pediatric gastroenterologist, Ochsner Children’s Hospital, in a press release.1

The authors suggest that a timely initiation of PERT can be a significant step in managing the symptoms associated with ARP as well as potentially changing the course of the disease. In addition, they highlight the genetic profiles of the patients within their research—particularly the SPINK1 mutation—and how they have a significant role in the efficacy of PERT in patients, emphasizing the necessity for personalized, medicinal approaches in treating diseases such as ARP, AP, and CP.1

Further, the authors also note how the study showcases the broader effects of PERT, and how it may be used outside of the reduction of AP episodes. PERT has the potential of decreasing the number of hospitalizations and medical interventions in children with acute episodes, as well as having positive influences on patients’ quality of life.1

The investigators note that additional research in the form of well-structured clinical trials is necessary to further confirm the safety and efficacy of PERT in controlled environments. This research has the potential to help with the development of standardized treatment protocols, which can enhance patient care and outcomes in pediatric patients with pancreatitis.1,2

"This research lays the groundwork for future clinical trials, aiming to optimize treatment strategies and improve the quality of life for these patients who have a disease that has historically been difficult to manage,” said Giefer in the press release.1

References
1. Ochsner Health System. Exploring the impact of pancreatic enzyme therapy in pediatric pancreatitis: a leap toward personalized medicine. News release. March 27, 2024. Accessed March 28, 2024. https://www.eurekalert.org/news-releases/1039311
2. Freeman, JA, Ng, K, Wang, F, et al. Pancreatic Enzyme Use Reduces Pancreatitis Frequency in Children with Acute Recurrent or Chronic Pancreatitis: A report from INSPPIRE. Am J Gastroenterol Suppl ():10.14309/ajg.0000000000002772, March 22, 2024. doi:10.14309/ajg.0000000000002772
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