Interventions for Pancreatitis-New Approaches, Knowledge Gaps, and Research Opportunities: Summary of a National Institute of Diabetes and Digestive and Kidney Diseases Workshop.

Abstract: There exists no cure for acute, recurrent acute or chronic pancreatitis and treatments to date have been focused on managing symptoms. A recent workshop held by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) focused on interventions that might disrupt or perhaps even reverse the natural course of this heterogenous disease, aiming to identify knowledge gaps and research opportunities that might inform future funding initiatives for NIDDK. The breadth and variety of identified active or planned clinical trials traverses the spectrum of the disease and was conceptually grouped for the workshop into behavioral, nutritional, pharmacologic and biologic, and mechanical interventions. Cognitive and other behavioral therapies are proven interventions for pain and addiction, but barriers exist to their use. Whilst a disease specific instrument quantifying pain is now validated, an equivalent is lacking for nutrition - and both face challenges in ease and frequency of administration. Multiple pharmacologic agents hold promise. Ongoing development of Patient Reported Outcome (PRO) measurements can satisfy Investigative New Drug (IND) regulatory assessments. Despite multiple randomized clinical trials demonstrating benefit, great uncertainty remains regarding patient selection, timing of intervention, and type of mechanical intervention (endoscopic versus surgery). Challenges and opportunities to establish beneficial interventions for patients were identified.
Competing Interests: All other authors report no relevant financial or other conflicts of interest. Disclosures: The following authors disclose potential conflicts of interest: A.E.P. (board member, National Pancreas Foundation), R.B. (board member, National Pancreas Foundation), G.C. (consultant, Olympus America; consultant, Interpace Diagnostics; scientific advisory board, Genprex), S.D. (corecipient of unrestricted industry research funding from Mylan Healthcare, expert panel for Mylan Healthcare), A.F. (consultant work for Takeda and Abbvie), C.F. (board member, National Pancreas Foundation; research support, Abbvie), M.R. (honoraria from Fresenius Kabi as speaker); V.S. (board member, National Panreas Foundation; consultant to Abbvie, Ariel Precision Medicine, Organon, Nestle Health Sciences, Panafina, and Horizon Therapeutics; scientific advisory board member and equity holder in Kyttaro and Origin Endoscopy), D.W. (consultant to Abbvie, Ariel Precision Medicine, Nestle, Organon, Regeneron; cofounder and chief scientific officer, Ariel Precision Medicine), and D.Y. (consultant, Pfizer Inc).
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)