TY - JOUR
T1 - Clinical and Practice Variations in Pediatric Acute Recurrent or Chronic Pancreatitis
T2 - Report From the INSPPIRE Study
AU - Dike, Chinenye R.
AU - Zimmerman, Bridget
AU - Zheng, Yuhua
AU - Wilschanski, Michael
AU - Werlin, Steven L.
AU - Troendle, David
AU - Shah, Uzma
AU - Schwarzenberg, Sarah Jane
AU - Pohl, John
AU - Perito, Emily R.
AU - Ooi, Chee Y.
AU - Nathan, Jaimie D.
AU - Morinville, Veronique D.
AU - McFerron, Brian
AU - Mascarenhas, Maria
AU - Maqbool, Asim
AU - Liu, Quin
AU - Lin, Tom K.
AU - Husain, Sohail Z.
AU - Heyman, Melvin B.
AU - Gonska, Tanja
AU - Giefer, Matthew J.
AU - Gariepy, Cheryl E.
AU - Fishman, Douglas S.
AU - Bellin, Melena
AU - Barth, Bradley
AU - Abu-El-Haija, Maisam
AU - Lowe, Mark E.
AU - Uc, Aliye
N1 - Funding Information:
Research reported in this publication was supported by National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award numbers R21 DK096327, U01 DK108334, R01 DK118752 (A.U.); INSPPIRE registry was developed by CTSA (2UL1 TR000442) and REDCap. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
M.L is on the Board of Directors of the National Pancreas Association; receives royalties from Millipore Inc and UpToDate. T.G. received a research grant from Vertex Pharmaceuticals and she is a consultant for Cystic Fibrosis Foundation. J.P. is on the speaker's bureau for Medical Education Resources, Inc.; M.B. is a consultant for AbbVie Inc and ARIEL Precision Medicine. S.Z.H. has equity in Prevcon. C.Y.O. is a consultant for Vertex Pharmaceuticals. M.W. received a research grant from Vertex Phamaceuticals. A.U. is a member of American Board of Pediatrics, Subboard of Pediatric Gastroenterology and Associate Editor of Pancreatology. The other authors declare no conflicts of interest.
Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Objective:The aim of the study was to determine whether clinical characteristics and management of pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) differ across INSPPIRE (INternational Study Group of Pediatric Pancreatitis: In Search for a cuRE) sites.Study Design:Data were collected from INSPPIRE and analyzed per US regions and "non-US" sites. Between-group differences were compared by Pearson chi-square test. Differences in disease burden were compared by Kruskal-Wallis test.Results:Out of the 479 subjects, 121 (25%) were enrolled in West, 151 (32%) Midwest, 45 Northeast (9%), 78 (16%) South, and 84 (18%) at non-US sites. Hispanic ethnicity was more common in South (P < 0.0001); white race in Northeast (P = 0.009). CP was less common and time from diagnosis of first acute pancreatitis to CP was longer in children at non-US sites (P = 0.0002 and P = 0.011, respectively). Genetic mutations were most common among all groups; PRSS1 variants predominated in Midwest (P = 0.002). Gallstones were more frequent in South (P = 0.002). Endoscopic retrograde cholangiopancreatography (ERCP) and computed tomography (CT) imaging were more commonly utilized in United States compared with non-United States (P < 0.0001), but there were no differences in the use of MRI/MRCP. Disease burden was highest in the West and Midwest, possibly as total pancreatectomy and islet autotransplantation (TPIAT) referral sites were located in these regions. All therapies were less commonly administered in non-US sites (P < 0.0001).Conclusions:This is the first study to describe geographical variations in the INSPPIRE cohort, which possibly reflect variations in practice and referral patterns. The underlying reason behind the lower frequency of CP and fewer treatments in non-United States sites need to be further explored.
AB - Objective:The aim of the study was to determine whether clinical characteristics and management of pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) differ across INSPPIRE (INternational Study Group of Pediatric Pancreatitis: In Search for a cuRE) sites.Study Design:Data were collected from INSPPIRE and analyzed per US regions and "non-US" sites. Between-group differences were compared by Pearson chi-square test. Differences in disease burden were compared by Kruskal-Wallis test.Results:Out of the 479 subjects, 121 (25%) were enrolled in West, 151 (32%) Midwest, 45 Northeast (9%), 78 (16%) South, and 84 (18%) at non-US sites. Hispanic ethnicity was more common in South (P < 0.0001); white race in Northeast (P = 0.009). CP was less common and time from diagnosis of first acute pancreatitis to CP was longer in children at non-US sites (P = 0.0002 and P = 0.011, respectively). Genetic mutations were most common among all groups; PRSS1 variants predominated in Midwest (P = 0.002). Gallstones were more frequent in South (P = 0.002). Endoscopic retrograde cholangiopancreatography (ERCP) and computed tomography (CT) imaging were more commonly utilized in United States compared with non-United States (P < 0.0001), but there were no differences in the use of MRI/MRCP. Disease burden was highest in the West and Midwest, possibly as total pancreatectomy and islet autotransplantation (TPIAT) referral sites were located in these regions. All therapies were less commonly administered in non-US sites (P < 0.0001).Conclusions:This is the first study to describe geographical variations in the INSPPIRE cohort, which possibly reflect variations in practice and referral patterns. The underlying reason behind the lower frequency of CP and fewer treatments in non-United States sites need to be further explored.
KW - acute recurrent pancreatitis
KW - chronic pancreatitis
KW - pancreas
KW - pancreatic disease
KW - pediatric pancreatitis
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U2 - 10.1097/MPG.0000000000002661
DO - 10.1097/MPG.0000000000002661
M3 - Article
C2 - 32079978
AN - SCOPUS:85086792951
SN - 0277-2116
VL - 71
SP - 112
EP - 118
JO - Journal of pediatric gastroenterology and nutrition
JF - Journal of pediatric gastroenterology and nutrition
IS - 1
ER -