| Use and perceived effectiveness of non-analgesic medical therapies for chronic pancreatitis in the United States. | |
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MedLine Citation:
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PMID: 21083584 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Effectiveness of medical therapies in chronic pancreatitis has been described in small studies of selected patients. AIM: To describe frequency and perceived effectiveness of non-analgesic medical therapies in chronic pancreatitis patients evaluated at US referral centres. METHODS: 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. RESULTS: Oral PERT was commonly used (70%), more frequently in the presence of exocrine insufficiency (EI) (88% vs. 61%, P < 0.001) and pain (74% vs. 59%, P < 0.002). 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 generally <50%. CONCLUSIONS: 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. |
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Authors:
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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; |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-10-29 |
Journal Detail:
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Title: Alimentary pharmacology & therapeutics Volume: 33 ISSN: 1365-2036 ISO Abbreviation: Aliment. Pharmacol. Ther. Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-06 Completed Date: 2011-05-06 Revised Date: 2012-01-04 |
Medline Journal Info:
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Nlm Unique ID: 8707234 Medline TA: Aliment Pharmacol Ther Country: England |
Other Details:
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Languages: eng Pagination: 149-59 Citation Subset: IM |
Copyright Information:
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© 2010 Blackwell Publishing Ltd. |
Affiliation:
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St. Louis University, MO, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Pain
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therapy* Adolescent Adult Aged Aged, 80 and over Antioxidants / therapeutic use* Autonomic Nerve Block / methods Enzyme Replacement Therapy Female Gastrointestinal Agents / therapeutic use* Humans Male Middle Aged Octreotide / therapeutic use* Pancreas / pathology Pancreatitis, Chronic Prospective Studies Questionnaires Treatment Outcome United States Vitamins / therapeutic use* Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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DK61451/DK/NIDDK NIH HHS; R01 DK061451-01/DK/NIDDK NIH HHS; R01 DK061451-02/DK/NIDDK NIH HHS; R01 DK061451-03/DK/NIDDK NIH HHS; R01 DK061451-04/DK/NIDDK NIH HHS; R01 DK061451-05/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antioxidants; 0/Gastrointestinal Agents; 0/Vitamins; 83150-76-9/Octreotide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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