Prescription patterns of pancreatic enzyme replacement therapy for patients with pancreatic cancer in the United States

Tejeshwar Jain; Prateek Sharma; Bhuwan Giri; Srikanth Iyer; Vrishketan Sethi; Ejas P. Bava; Utpreksha Vaish; Preeti Sahay; Jashodeep Datta; Sushanth Reddy; John Bart Rose; Anam Khan; Nipun Merchant; Suresh T. Chari; Vikas Dudeja

doi:10.1016/j.hpb.2022.05.003

Prescription patterns of pancreatic enzyme replacement therapy for patients with pancreatic cancer in the United States

Tejeshwar Jain, Prateek Sharma, Bhuwan Giri, Srikanth Iyer, Vrishketan Sethi, Ejas P. Bava, Utpreksha Vaish, Preeti Sahay, Jashodeep Datta, Sushanth Reddy, John Bart Rose, Anam Khan, Nipun Merchant, Suresh T. Chari, Vikas Dudeja

Gastroenterology Hepatology & Nutrition

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Background: Exocrine pancreatic insufficiency (EPI) is frequently seen in patients with pancreatic cancer (PDAC) and is thought to contribute to nutritional complications. While EPI can be pharmacologically temporized with pancreatic enzyme replacement therapy (PERT), there is lack of clear evidence informing its use in PDAC. Here we aim to survey pancreatic surgeons regarding their utilization of PERT in the management of EPI for PDAC. Methods: An online survey was distributed to the members of The Americas Hepato-Pancreato-Biliary Association (AHPBA) and The Pancreas Club. Results: 86.5% (180/208) of surgeons prescribe PERT for at least some resectable/borderline resectable PDAC cases. Only a minority of surgeons order investigations to confirm EPI before starting PERT (28.1%) or test for adequacy of therapy (28.3%). Few surgeons believe that PERT has an effect on overall survival (19.7%) or disease-free survival (6.25%) in PDAC. Conclusion: PERT is widely prescribed in patients with resectable/borderline resectable PDAC, but investigations establishing EPI and assessing PERT adequacy are underutilized. A substantial proportion of surgeons are unclear as to the effect of PERT on survival outcomes in PDAC. These data call for prospective studies to establish guidelines for optimal use of PERT and its effects on survival outcomes in PDAC.

Original language	English (US)
Pages (from-to)	1729-1737
Number of pages	9
Journal	HPB
Volume	24
Issue number	10
DOIs	https://doi.org/10.1016/j.hpb.2022.05.003
State	Published - Oct 2022

ASJC Scopus subject areas

Hepatology
Gastroenterology

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Jain, T., Sharma, P., Giri, B., Iyer, S., Sethi, V., Bava, E. P., Vaish, U., Sahay, P., Datta, J., Reddy, S., Bart Rose, J., Khan, A., Merchant, N., Chari, S. T., & Dudeja, V. (2022). Prescription patterns of pancreatic enzyme replacement therapy for patients with pancreatic cancer in the United States. HPB, 24(10), 1729-1737. https://doi.org/10.1016/j.hpb.2022.05.003

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title = "Prescription patterns of pancreatic enzyme replacement therapy for patients with pancreatic cancer in the United States",

abstract = "Background: Exocrine pancreatic insufficiency (EPI) is frequently seen in patients with pancreatic cancer (PDAC) and is thought to contribute to nutritional complications. While EPI can be pharmacologically temporized with pancreatic enzyme replacement therapy (PERT), there is lack of clear evidence informing its use in PDAC. Here we aim to survey pancreatic surgeons regarding their utilization of PERT in the management of EPI for PDAC. Methods: An online survey was distributed to the members of The Americas Hepato-Pancreato-Biliary Association (AHPBA) and The Pancreas Club. Results: 86.5% (180/208) of surgeons prescribe PERT for at least some resectable/borderline resectable PDAC cases. Only a minority of surgeons order investigations to confirm EPI before starting PERT (28.1%) or test for adequacy of therapy (28.3%). Few surgeons believe that PERT has an effect on overall survival (19.7%) or disease-free survival (6.25%) in PDAC. Conclusion: PERT is widely prescribed in patients with resectable/borderline resectable PDAC, but investigations establishing EPI and assessing PERT adequacy are underutilized. A substantial proportion of surgeons are unclear as to the effect of PERT on survival outcomes in PDAC. These data call for prospective studies to establish guidelines for optimal use of PERT and its effects on survival outcomes in PDAC.",

author = "Tejeshwar Jain and Prateek Sharma and Bhuwan Giri and Srikanth Iyer and Vrishketan Sethi and Bava, {Ejas P.} and Utpreksha Vaish and Preeti Sahay and Jashodeep Datta and Sushanth Reddy and {Bart Rose}, John and Anam Khan and Nipun Merchant and Chari, {Suresh T.} and Vikas Dudeja",

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year = "2022",

month = oct,

doi = "10.1016/j.hpb.2022.05.003",

language = "English (US)",

volume = "24",

pages = "1729--1737",

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T1 - Prescription patterns of pancreatic enzyme replacement therapy for patients with pancreatic cancer in the United States

AU - Jain, Tejeshwar

AU - Sharma, Prateek

AU - Giri, Bhuwan

AU - Iyer, Srikanth

AU - Sethi, Vrishketan

AU - Bava, Ejas P.

AU - Vaish, Utpreksha

AU - Sahay, Preeti

AU - Datta, Jashodeep

AU - Reddy, Sushanth

AU - Bart Rose, John

AU - Khan, Anam

AU - Merchant, Nipun

AU - Chari, Suresh T.

AU - Dudeja, Vikas

PY - 2022/10

Y1 - 2022/10

N2 - Background: Exocrine pancreatic insufficiency (EPI) is frequently seen in patients with pancreatic cancer (PDAC) and is thought to contribute to nutritional complications. While EPI can be pharmacologically temporized with pancreatic enzyme replacement therapy (PERT), there is lack of clear evidence informing its use in PDAC. Here we aim to survey pancreatic surgeons regarding their utilization of PERT in the management of EPI for PDAC. Methods: An online survey was distributed to the members of The Americas Hepato-Pancreato-Biliary Association (AHPBA) and The Pancreas Club. Results: 86.5% (180/208) of surgeons prescribe PERT for at least some resectable/borderline resectable PDAC cases. Only a minority of surgeons order investigations to confirm EPI before starting PERT (28.1%) or test for adequacy of therapy (28.3%). Few surgeons believe that PERT has an effect on overall survival (19.7%) or disease-free survival (6.25%) in PDAC. Conclusion: PERT is widely prescribed in patients with resectable/borderline resectable PDAC, but investigations establishing EPI and assessing PERT adequacy are underutilized. A substantial proportion of surgeons are unclear as to the effect of PERT on survival outcomes in PDAC. These data call for prospective studies to establish guidelines for optimal use of PERT and its effects on survival outcomes in PDAC.

AB - Background: Exocrine pancreatic insufficiency (EPI) is frequently seen in patients with pancreatic cancer (PDAC) and is thought to contribute to nutritional complications. While EPI can be pharmacologically temporized with pancreatic enzyme replacement therapy (PERT), there is lack of clear evidence informing its use in PDAC. Here we aim to survey pancreatic surgeons regarding their utilization of PERT in the management of EPI for PDAC. Methods: An online survey was distributed to the members of The Americas Hepato-Pancreato-Biliary Association (AHPBA) and The Pancreas Club. Results: 86.5% (180/208) of surgeons prescribe PERT for at least some resectable/borderline resectable PDAC cases. Only a minority of surgeons order investigations to confirm EPI before starting PERT (28.1%) or test for adequacy of therapy (28.3%). Few surgeons believe that PERT has an effect on overall survival (19.7%) or disease-free survival (6.25%) in PDAC. Conclusion: PERT is widely prescribed in patients with resectable/borderline resectable PDAC, but investigations establishing EPI and assessing PERT adequacy are underutilized. A substantial proportion of surgeons are unclear as to the effect of PERT on survival outcomes in PDAC. These data call for prospective studies to establish guidelines for optimal use of PERT and its effects on survival outcomes in PDAC.

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Prescription patterns of pancreatic enzyme replacement therapy for patients with pancreatic cancer in the United States

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