Alcohol-Related Chronic Pancreatitis Linked to Better Outcomes Than Non-Alcohol-Related Disease

New research is providing clinicians with an overview of etiology-based differences in chronic pancreatitis, highlighting lower rates of serious clinical outcomes and the need for therapeutic interventions in patients with alcohol-related chronic pancreatitis (ARCP) compared to those with non-alcohol-related chronic pancreatitis (NARCP).1

The study leveraged TriNetX US Collaborative Network data to create propensity score matched (PSM) cohorts for each etiology, with results highlighting lower rates of mortality, diabetes, exocrine pancreatic insufficiency, and other clinical outcomes in the ARCP group versus the NARCP group. By recognizing these differences, clinicians may be able to better optimize treatment plans, improve patient outcomes, and potentially reduce healthcare costs associated with chronic pancreatitis.1

A progressive fibroinflammatory disease, chronic pancreatitis is characterized by irreversible damage to the pancreatic tissue, resulting in exocrine and endocrine dysfunction. As the disease progresses, patients often experience debilitating symptoms that significantly impact their quality of life and may develop chronic abdominal pain, malabsorption due to exocrine insufficiency, and diabetes mellitus. Due to its complex pathophysiology and varied clinical manifestations, early recognition and a comprehensive management approach are regarded as essential for improving patient outcomes.2

“Understanding the different outcomes of patients with ARCP versus NARCP is essential for optimizing patient care and developing tailored therapeutic strategies,” Khaled Elfert, a gastroenterology and hepatology fellow at West Virginia University Medical School, and colleagues wrote.1

To distinguish the prognosis and therapeutic needs of ARCP versus NARCP, investigators conducted a retrospective cohort study utilizing the TriNetX US Collaborative Network. Inclusion criteria were adult patients ≥ 18 years of age with a diagnosis of chronic pancreatitis. Patients were stratified into 2 groups, ARCP and NARCP, based on the documented etiology using ICD-10 codes.1

Investigators employed 1:1 PSM to balance baseline characteristics between both cohorts. The primary outcome was mortality from the time of chronic pancreatitis diagnosis up to 10 years of follow-up. Secondary outcomes included exocrine pancreatic insufficiency, pseudocyst formation, development of diabetes and pancreatic cancer, and need for ERCP and celiac plexus injection.1

A total of 203,432 patients with chronic pancreatitis were identified, including 11,696 with ARCP and 200,560 with NARCP. After PSM, both cohorts included 11,678 patients with nearly identical mean ages (49.9 ± 13.6 vs 49.9 ± 14.2 years) and comparable sex distributions (67.1% vs 67.6% male and 31.6% vs 31.1% female, respectively). Investigators noted racial and ethnic characteristics were also similarly balanced following matching.1

After PSM, ARCP was associated with significantly lower rates of mortality (13.0% vs 16.2%; risk ratio (RR), 0.80), diabetes (22.9% vs 35.8%; RR, 0.64), exocrine pancreatic insufficiency (2.0% vs 6.1%; RR, 0.32), pancreatic cancer (1.1% vs 8.4%; RR, 0.14), and pseudocyst formation (7.1% vs 9.7%; RR, 0.73) compared to NARCP (all P <.001).1

Further analysis revealed ARCP patients also had lower rates of celiac plexus injection (0.1% vs 0.8%; RR, 0.12) and ERCP (2.3% vs 10.2%; RR, 0.23) (both P <.001).1

“This study highlights significant differences in the clinical outcomes and therapeutic needs of patients with ARCP and NARCP, emphasizing the value of etiology-based treatment strategies,” investigators concluded.1 “Lower rates of mortality, complications, and interventions in patients with alcohol-related disease than in those with non-alcohol-associated disease provide important insights into disease patterns that may influence prognosis and guide therapeutic decisions.”

References

1. Elfert K, Abusuliman M, Eldesouki M, et al. The Impact of Chronic Pancreatitis Etiology on Clinical Outcomes: A Population-Based Propensity-Matched Analysis. Gastroenterology Res. 2025;18(6):269-275. doi:10.14740/gr2050

2. Goosenberg E, Lappin SL. Chronic Pancreatitis. StatPearls. April 4, 2025. Accessed January 7, 2026. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482325/