{
  "abstract": "Introduction Chronic pancreatitis (CP) is a debilitating inflammatory condition characterised by irreversible glandular destruction and intractable pain. Management is frequently limited to symptomatic control, often resulting in chronic opioid dependence and the need for repeated invasive endoscopic or surgical interventions. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated anti-inflammatory properties in preclinical models of pancreatitis, yet their impact on clinical outcomes in CP remains unexplored.Methods In this retrospective cohort study using the TriNetX US Collaborative Network, adult patients with a diagnosis of CP were identified. Patients were stratified into two cohorts: those prescribed GLP-1 RAs (dulaglutide, semaglutide, or tirzepatide) and a control group with no exposure to GLP-1-based therapies. 1:1 propensity score matching was performed to balance cohorts for age, sex, race, and key comorbidities (including type 2 diabetes, alcohol use, and tobacco use). Primary outcomes assessed over a 3-year follow-up included new chronic opioid prescriptions, diagnosis of opioid use disorder (OUD), celiac plexus block/neurolysis, endoscopic pancreatic interventions, and major pancreatic surgery. Hazard Ratios (HR) with 95% confidence intervals (CI) were estimated using Kaplan-Meier survival analysis.Results After matching, 10,625 patients were included in each cohort (mean age 59.6 ± 13.1 years; 53.7% female). GLP-1 RA use was associated with significantly reduced risks across all evaluated outcomes compared to the control group. Patients in the GLP-1 RA cohort had a 41% lower hazard of initiating chronic opioids (HR 0.59, 95% CI 0.52–0.67; p<0.001) and a 42% lower hazard of developing OUD (HR 0.58, 95% CI 0.48–0.69; p<0.001). Regarding invasive interventions, GLP-1 RA therapy was associated with a marked reduction in the risk of requiring celiac plexus block (HR 0.51, 95% CI 0.34–0.78; p=0.001) and endoscopic pancreatic interventions (HR 0.48, 95% CI 0.41–0.56; p<0.001). Furthermore, the risk of undergoing major pancreatic surgery (including resection or drainage procedures) was significantly lower in the GLP-1 RA group (HR 0.44, 95% CI 0.33–0.59; p<0.001).Conclusions In this large real-world cohort of chronic pancreatitis patients, GLP-1 RA therapy was associated with a substantial reduction in the need for chronic opioid therapy, development of opioid use disorder, and requirement for invasive endoscopic or surgical interventions. These findings suggest that GLP-1 RAs may exert a disease-modifying effect or provide superior pain modulation in CP. Further prospective studies are warranted to validate these findings and elucidate the underlying mechanisms.Abstract O75 Figure 1Clinical outcomes in chronic pancreatitis (GLP-1 RA vs. control)",
  "authors": [
    {
      "affiliations": [
        "Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom",
        "Imperial College London, London, United Kingdom"
      ],
      "name": "Arkadeep Dhali"
    },
    {
      "affiliations": [
        "Indian Institute of Technology Kharagpur, Kharagpur, India"
      ],
      "name": "Rick Maity"
    },
    {
      "affiliations": [
        "Roswell Park Comprehensive Cancer Center, Buffalo, USA"
      ],
      "name": "Fayaz Khan"
    },
    {
      "affiliations": [
        "Barasat Government Medical College and Hospital, Barasat, India"
      ],
      "name": "Jyotirmoy Biswas"
    }
  ],
  "title": "O75 Glucagon-like peptide-1 receptor agonists and risks of opioid use and invasive interventions in chronic pancreatitis: a real-world cohort study",
  "uid": "3b2e0fd2-1507-5fbd-8bd3-a443bee8d4a2"
}