A meta-analysis in Pancreatology disparages all 9 studies that investigated using pancreatic enzyme supplements for chronic pancreatitis, saying the studies are too flawed to support any conclusion whatsoever.
* Few studies used uncoated enzymes (the recommended treatment).
* Only one study tried to determine whether subjects were using alcohol (the major risk factor).
* Most used crossover designs, but only one study included a washout period.
The only clinical guideline on the question, from the American Gastroenterological Association (AGA), predates these studies. In sum, the best approach for this painful condition is still unknown.
The review recommends following existing guidelines, but offers specific caveats about the use of pancreatic enzymes.
(The guideline itself is not published online, even in abstract form, although you’ll see the citation here, listed as “AGA Technical Review: Treatment of Pain in Chronic Pancreatitis.” However, the first result in this search, from the Cleveland Clinic, reviews the AGA treatment recommendations in detail.)
Another recent study identifies smoking as a risk factor for chronic pancreatitis.
Clinical Trials
Look in this category for ongoing trials of enzyme treatment for chronic pancreatitis.
IN THE JOURNALS
What have your colleagues been looking at on SearchMedica?
Search term: pancreatic cancer
An NIH study involving over 450,000 subjects identifies 5 modifiable lifestyle factors that significantly reduce the risk of pancreatic cancer.
Search term: resident workload
A new study in the New England Journal of Medicine shows that it would cost hospitals about $183 per patient to implement new Institute of Medicine guidelines to improve working conditions for residents.
Search term: non-ST myocardial infarction
Older women fare better than men after STEMI, but younger women fare worse than men.
NOTEWORTHY SEARCH of the week
Lessons from a genuine clinical search
A colleague wrote in to recommend this article published in 2000, the first result from the search on central nervous system vasculitis.
RESULT #1: Polymyalgia Rheumatica and Temporal Arteritis
American Family Physician
TIP: We always wonder when we see positive feedback about a fairly dated result: Did the writer realize that the option to include publication date in search criteria had been turned off?
It’s possible that you want to see the most relevant review, rather than the most recent one. But do remember to check whether you’ve made that choice intentionally. Leaving the option “Prioritize results by publication date” un-checked searches by relevance only.
Enabling the date-ranking option, good results appear with the search polymyalgia rheumatica.
