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. 2025 Aug 26;61(9):1532.
doi: 10.3390/medicina61091532.

Acute Pancreatitis in Inflammatory Bowel Disease: Results from the European Pandora Study

Maria Cristina Conti Bellocchi  1 , Martina Cattani Mottes  1 , Andreas Blesl  2 , Anneline Cremer  3 , Stefano Festa  4 , Mathieu Uzzan  5 , Tiago Cúrdia Gonçalves  6   7   8 , Antonio Rispo  9 , Chiara Viganò  10 , Ioannis Koutroubakis  11 , Antonietta Gerarda Gravina  12 , Daniela Pugliese  13 , Piotr Eder  14 , Sophie Vieujean  15 , Massimo Claudio Fantini  16 , Clara Yzet  17 , Konstantinos Argyriou  18 , Lieven Pouillon  19 , Davide Giuseppe Ribaldone  20 , Andrea Michielan  21 , Marie Truyens  22 , Anna Viola  23 , Edoardo Vincenzo Savarino  24 , Pierre Ellul  25 , Javier P Gisbert  26 , Vrakas Spyridon  27 , Michele Campigotto  28 , Raquel Oliveira  29 , Angela Variola  30 , Laura Loy  31 , Aldis Pukitis  32 , Maria Fragaki  33 , Alessia Dalila Guarino  9 , Aikaterini Mantaka  34 , Laura Ramos  35 , Stefano Francesco Crinò  1 , Rachele Ciccocioppo  36 , Luca Frulloni  36 , Pandora Study Group
Affiliations

Acute Pancreatitis in Inflammatory Bowel Disease: Results from the European Pandora Study

Maria Cristina Conti Bellocchi et al. Medicina (Kaunas). .

Abstract

Background and aims: An increased risk of acute pancreatitis (AP) has been reported in patients with inflammatory bowel disease (IBD), but data on its prevalence, etiology, and outcomes are limited. Materials and Methods: A two-step retrospective analysis spanning 10 years (2011-2020) was conducted across 34 European centers. The first step surveyed the prevalence of AP in patients with IBD, while the second gathered data on disease characteristics, etiology, and outcomes. Results: The survey found an expected AP prevalence of 1.13% (780/68,989), though only 0.58% (n = 398) met the inclusion criteria. The mean age was 33.6 ± 14.3; 52% were female, and 56.5% had Crohn's disease (CD). AP was clinically mild in most cases (86.9%). Among 347 patients with available imaging, no alterations were observed in 81 (23.3%), whereas edematous AP was observed in 218 (62.8%). Drugs (mainly azathioprine) were the leading cause (55.3%), followed by biliary (14.8%) and autoimmune (7.8%) causes. In 13.5% of patients, AP was considered idiopathic. During a median follow-up of 67 months [IQR 34-96] from the index episode, recurrence was observed in 13% of patients, and 1.5% developed chronic pancreatitis. CD patients exhibited distinct risk profiles, including ileal involvement and smoking, whereas ulcerative colitis (UC) patients showed more frequent autoimmune and idiopathic etiologies. Conclusions: The PANDORA study established a 0.58% prevalence of AP in IBD patients, which was lower than expected. AP is usually mild both clinically and radiologically. An ileal location in CD and extensive colitis in UC are usually reported, and azathioprine seems to be the most common cause of AP in this setting, especially a few weeks after its introduction.

Keywords: Crohn’s disease; IBD; autoimmune pancreatitis; pancreatitis; ulcerative colitis.

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Conflict of interest statement

The authors declared no financial interests or connections, direct or indirect, or other situations that might raise the question of bias in the work reported or the conclusions, implications, or opinions stated.

Figures

Figure 1
Figure 1
Pie charts representing the survey results.
Figure 2
Figure 2
Column chart representing the etiology of IBD in three groups of patients with different intervals between acute pancreatitis (AP) and inflammatory bowel disease (IBD) diagnosis.
Figure 3
Figure 3
Different etiology of acute pancreatitis in Crohn’s disease and ulcerative colitis.
Figure 4
Figure 4
Box and whiskers plot summarizes the interval between thiopurine therapy starting and acute pancreatitis (AP) onset.
See this image and copyright information in PMC

References

    1. Antonini F., Pezzilli R., Angelelli L., Macarri G. Pancreatic disorders in inflammatory bowel disease. World J. Gastrointest. Pathophysiol. 2016;7:276–282. doi: 10.4291/wjgp.v7.i3.276. - DOI - PMC - PubMed
    1. Ramos L.R., Sachar D.B., DiMaio C.J., Colombel J.F., Torres J. Inflammatory Bowel Disease and Pancreatitis: A Review. J. Crohns Colitis. 2016;10:95–104. doi: 10.1093/ecco-jcc/jjv153. - DOI - PubMed
    1. Saini J., Marino D., Badalov N., Vugelman M., Tenner S. Drug-Induced Acute Pancreatitis: An Evidence-Based Classification (Revised) Clin. Transl. Gastroenterol. 2023;14:e00621. doi: 10.14309/ctg.0000000000000621. - DOI - PMC - PubMed
    1. Badalov N., Baradarian R., Iswara K., Li J., Steinberg W., Tenner S. Drug-induced acute pancreatitis: An evidence-based review. Clin. Gastroenterol. Hepatol. 2007;5:648–661. doi: 10.1016/j.cgh.2006.11.023. - DOI - PubMed
    1. Lee A.A., Gupta S., Labban M., Cao F.T., Trinh Q.D., McNabb-Baltar J. Drug-induced acute pancreatitis due to medications used for inflammatory bowel disease: A VigiBase pharmacovigilance database study. Pancreatology. 2023;23:569–573. doi: 10.1016/j.pan.2023.06.003. - DOI - PubMed

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