Use and perceived effectiveness of non-analgesic medical therapies for chronic pancreatitis in the United States

Autor: F, Burton, S, Alkaade, D, Collins, V, Muddana, A, Slivka, R E, Brand, A, Gelrud, P A, Banks, S, Sherman, M A, Anderson, J, Romagnuolo, C, Lawrence, J, Baillie, T B, Gardner, M D, Lewis, S T, Amann, J G, Lieb, M, O'Connell, E D, Kennard, D, Yadav, D C, Whitcomb, C E, Forsmark
Rok vydání: 2010
Předmět:
Zdroj: Alimentary pharmacologytherapeutics. 33(1)
ISSN: 1365-2036
Popis: Effectiveness of medical therapies in chronic pancreatitis has been described in small studies of selected patients.To describe frequency and perceived effectiveness of non-analgesic medical therapies in chronic pancreatitis patients evaluated at US referral centres.Using data on 516 chronic pancreatitis patients enrolled prospectively in the NAPS2 Study, we evaluated how often medical therapies [pancreatic enzyme replacement therapy (PERT), vitamins/antioxidants (AO), octreotide, coeliac plexus block (CPB)] were utilized and considered useful by physicians.Oral PERT was commonly used (70%), more frequently in the presence of exocrine insufficiency (EI) (88% vs. 61%, P0.001) and pain (74% vs. 59%, P0.002). On multivariable analyses, predictors of PERT usage were EI (OR 5.14, 95% CI 2.87-9.18), constant (OR 3.42, 95% CI 1.93-6.04) or intermittent pain (OR 1.98, 95% CI 1.14-3.45). Efficacy of PERT was predicted only by EI (OR 2.16, 95% CI 1.36-3.42). AO were tried less often (14%) and were more effective in idiopathic and obstructive vs. alcoholic chronic pancreatitis (25% vs. 4%, P = 0.03). Other therapies were infrequently used (CPB - 5%, octreotide - 7%) with efficacy generally50%.Pancreatic enzyme replacement therapy is commonly utilized, but is considered useful in only subsets of chronic pancreatitis patients. Other medical therapies are used infrequently and have limited efficacy.
Databáze: OpenAIRE
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