TOPLINE:
The overall progression to chronic pancreatitis among adults was three times higher following recurrent episodes of acute pancreatitis than occurring after just the first acute pancreatitis episode.
METHODOLOGY:
- The progression of acute pancreatitis is time-dependent, with the recurrence and progression rates to recurrent acute pancreatitis and chronic pancreatitis varying based on the follow-up duration and may be affected by the cause and severity of the first acute episode.
- To better understand the progression of acute pancreatitis to recurrent acute pancreatitis and chronic pancreatitis, researchers conducted a systematic review and meta-analysis of 119 studies, all of which were used for qualitative and quantitative synthesis and 29 of which also were used for calculating incidence rates.
- The primary outcomes were the incidence rates of recurrent acute and chronic pancreatitis following the initial episode of acute pancreatitis and the incidence rate of chronic pancreatitis after recurrent episodes of acute pancreatitis.
- The secondary outcomes were the cumulative incidences and proportions of recurrent acute and chronic pancreatitis following the initial acute pancreatitis episode and the proportion of chronic pancreatitis occurring after recurrent acute pancreatitis episodes.
TAKEAWAY:
- The incidence rate of recurrent acute pancreatitis after the first acute episode was 5.26 per 100 person-years in adults and 4.64 per 100 person-years in children, a difference that did not reach statistical significance.
- The progression rate to chronic pancreatitis in adults was threefold higher after recurrent acute pancreatitis episodes than after the first acute pancreatitis episode (4.31 vs 1.38 per 100 person-years).
- Hypertriglyceridemia-induced acute pancreatitis had the highest recurrence rates, followed by alcohol-induced, idiopathic, and biliary pancreatitis.
- The overall progression rate into chronic pancreatitis was 8% after the first acute pancreatitis episode and 24% after recurrent episodes of acute pancreatitis. Progression to chronic pancreatitis among adults was highest among those with alcohol-induced disease, followed by idiopathic and biliary pancreatitis.
- A moderately severe first episode of acute pancreatitis was associated with the highest recurrence rate, followed by mild and severe first episodes.
IN PRACTICE:
The authors emphasized the need to develop new interventions to address the factors associated with acute pancreatitis and its progression and to better utilize existing approaches, such as brief and repeated psychological interventions and alcohol and smoking cessation programs. Deeper investigation into the underlying causes of the disease’s etiology is warranted to reduce recurrence and progression rates, they noted.
SOURCE:
The study, led by Endre-Botond Gagyi, MD, of the Center for Translational Medicine, Semmelweis University, Budapest, Hungary, was published online in Therapeutic Advances in Gastroenterology.
LIMITATIONS:
Most of the studies included in the analysis were retrospective, and there was high heterogeneity between them. The researchers could only analyze the presence of recurrent acute pancreatitis but could not explore the number of episodes or their impact on progression due to the lack of reported data.
DISCLOSURES:
The study was funded by the New National Excellence Program of the Ministry for Innovation and Technology from the National Research, Development and Innovation Fund. The authors declared no conflict of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article appeared on Medscape.com.