A novel prospective registry, PACT-CP (PAtient-CenTric Chronic Pancreatitis), is shedding light on the epidemiology, symptom burden and patient experience of patients with recurrent acute pancreatitis or chronic pancreatitis and exocrine pancreatic insufficiency.
The registry includes US-based adult patients with RAP or CP and suspected or confirmed EPI who are receiving pancreatic enzyme replacement therapy (PERT) (ClinicalTrials.gov Identifier: NCT05762445).
Patients with cystic fibrosis, fibrosing colonopathy or malignancy are ineligible, and patients are followed for up to five years. Initial results were presented at DDW 2025 (abstract 1439).
Among 188 patients enrolled in the registry as of August 2024, 30 (16%) had RAP and 158 (84%) had CP. The average age of RAP patients was 55.2 years, compared with 60.7 for CP. Most RAP patients were female (59.3%), whereas most CP patients were male (52.7%). Most patients in both cohorts were white (RAP, 92.6%; CP, 81.3%).
Providers reported at least one baseline etiology of RAP or CP for patients. The five most common etiologies of RAP were alcohol susceptibility/progression (36.7%), idiopathic late onset (>35 years of age) (30.0%), tobacco smoking (26.7%), diabetes (20.0%) and hyperlipidemia (16.7%). The five most common etiologies of CP were idiopathic late onset (>35 years of age) (51.3%), alcohol susceptibility/progression (36.7%), diabetes (34.8%), tobacco smoking (20.9%) and main duct stones (13.9%). Of note, 13% of CP patients had RAP as a baseline CP etiology.
Common gastrointestinal and nutritional manifestations of EPI among participants at baseline included abdominal pain (RAP, 90%; CP, 71%), diarrhea/loose stool (RAP, 70%; CP, 70%), bloating (RAP, 57%; CP, 57%) and weight loss (RAP, 63%; CP, 50%).
Most patients reported that PERT use (median, at least PERT capsules per day for both RAP and CP groups) somewhat or greatly improved their symptoms. However, CP patients were around twice as likely as RAP patients to report that their general health was very good or excellent.
—Natasha Albaneze, MPH
