{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:55:21Z","timestamp":1790754921256,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The prevalence of chronic pancreatitis (CP) is increasing in Japan. This study aimed to elucidate the current status of pancreatic exocrine insufficiency (PEI) diagnosis and the prescription of pancreatic enzyme replacement therapy (PERT) in Japanese patients with CP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study using a large\u2010scale claims database in Japan with a data collection period between April 2008 and August 2022. Patients with CP were categorized into PERT and no\u2010PERT cohorts based on the presence or absence of PERT prescriptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found an increase in the number of CP diagnoses, PERT prescriptions, and PEI diagnoses over the past decade. The median PERT persistence time was 254.0\u2009days (95% confidence interval: 219.0\u2013288.0), and the 5\u2010year persistence rate was 20.4%. Patients in the PERT cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093056) were younger (61.9 vs. 65.4\u2009years), had a higher mean Charlson Comorbidity Index (1.7 vs. 1.3), and were more likely to be underweight (body mass index &lt;\u200918.5\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , 13.7% vs. 6.0%) than those in the no\u2010PERT cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932\u2009861). Patients in the PERT cohort had higher rates of in\u2010hospital deaths (6.3% vs. 4.7%), weight loss (13.3% vs. 9.2%), pancreatic diabetes (1.7% vs. 0.7%), and pancreatic cancer (1.7% vs. 0.7%) than those in the no\u2010PERT cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The number of PEI diagnoses and PERT prescriptions for patients with CP has increased in Japan over the past decade. The low PERT persistence rate suggests the need for further research to understand the factors that affect treatment persistence in CP management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.70473","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:56:21Z","timestamp":1790751381000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Current Status of Pancreatic Exocrine Insufficiency Diagnosis and Pancreatic Enzyme Replacement Therapy Implementation in Patients With Chronic Pancreatitis"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4591-1115","authenticated-orcid":false,"given":"Noriharu","family":"Itoh","sequence":"first","affiliation":[{"name":"Medical Affairs, Viatris Pharmaceuticals Japan G.K.  Minato\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Hasebe","sequence":"additional","affiliation":[{"name":"Medical Affairs, Viatris Pharmaceuticals Japan G.K.  Minato\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Yada","sequence":"additional","affiliation":[{"name":"EPS Corporation  Shinjuku\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4245-2657","authenticated-orcid":false,"given":"Kazutaka","family":"Nozawa","sequence":"additional","affiliation":[{"name":"Medical Affairs, Viatris Pharmaceuticals Japan G.K.  Minato\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"17060","DOI":"10.1038\/nrdp.2017.60","article-title":"Chronic Pancreatitis","volume":"3","author":"Kleeff J.","year":"2017","journal-title":"Nature Reviews Disease Primers"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1038\/ajg.2017.42","article-title":"Quality of Life in Chronic Pancreatitis Is Determined by Constant Pain, Disability\/Unemployment, Current Smoking, and Associated Co\u2010Morbidities","volume":"112","author":"Machicado J. D.","year":"2017","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1038\/ajg.2017.218","article-title":"Chronic Pancreatitis and Pancreatic Cancer Risk: A Systematic Review and Meta\u2010Analysis","volume":"112","author":"Kirkeg\u00e5rd J.","year":"2017","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1007\/s005350300058","article-title":"Chronic Pancreatitis in Japan: Epidemiology, Prognosis, Diagnostic Criteria, and Future Problems","volume":"38","author":"Otsuki M.","year":"2003","journal-title":"Journal of Gastroenterology"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1007\/s00535-020-01704-9","article-title":"Nationwide Epidemiological Survey of Chronic Pancreatitis in Japan: Introduction and Validation of the New Japanese Diagnostic Criteria 2019","volume":"55","author":"Masamune A.","year":"2020","journal-title":"Journal of Gastroenterology"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1080\/00365520510023116","article-title":"Prevalence and Determinants of Exocrine Pancreatic Insufficiency Among Older Adults: Results of a Population\u2010Based Study","volume":"40","author":"Rothenbacher D.","year":"2005","journal-title":"Scandinavian Journal of Gastroenterology"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/1471-2318-11-4","article-title":"Fecal Pancreatic Elastase\u20101 Levels in Older Individuals Without Known Gastrointestinal Diseases or Diabetes Mellitus","volume":"11","author":"Herzig K. H.","year":"2011","journal-title":"BMC Geriatrics"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1001\/jama.2019.19411","article-title":"Diagnosis and Management of Chronic Pancreatitis: A Review","volume":"322","author":"Singh V. K.","year":"2019","journal-title":"JAMA"},{"key":"e_1_2_11_10_1","unstructured":"S. L. . K. V.SuleimanandD. L.Conwell \u201cPancreatic Exocrine Insufficiency: Part 1 of 2: Pathogenic and Diagnostic Considerations \u201dCited 2025 December 1 https:\/\/www.gastroendonews.com\/download\/Pancreatic_CaPart1_WM.pdf."},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1111\/j.1365-2036.2012.05202.x","article-title":"Randomised Clinical Trial: The Efficacy and Safety of Pancreatin Enteric\u2010Coated Minimicrospheres (Creon 40000\u2009MMS) in Patients With Pancreatic Exocrine Insufficiency due to Chronic Pancreatitis\u2014A Double\u2010Blind, Placebo\u2010Controlled Study","volume":"36","author":"Thorat V.","year":"2012","journal-title":"Alimentary Pharmacology & Therapeutics"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1111\/j.1365-2036.2011.04631.x","article-title":"A 6\u2010Month, Open\u2010Label Clinical Trial of Pancrelipase Delayed\u2010Release Capsules (Creon) in Patients With Exocrine Pancreatic Insufficiency due to Chronic Pancreatitis or Pancreatic Surgery","volume":"33","author":"Gubergrits N.","year":"2011","journal-title":"Alimentary Pharmacology & Therapeutics"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1155\/2003\/515848","article-title":"Quality of Life Assessment After Pancreatic Enzyme Replacement Therapy in Chronic Pancreatitis","volume":"17","author":"Czak\u00f3 L.","year":"2003","journal-title":"Canadian Journal of Gastroenterology"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1007\/s00535-022-01911-6","article-title":"Evidence\u2010Based Clinical Practice Guidelines for Chronic Pancreatitis 2021","volume":"57","author":"Shimizu K.","year":"2022","journal-title":"Journal of Gastroenterology"},{"key":"e_1_2_11_15_1","unstructured":"VIATRIS \u201cLipaCreon Granules\/Capsules Package Insert [in Japanese] \u201dhttps:\/\/www.pmda.go.jp\/PmdaSearch\/iyakuDetail\/GeneralList\/2331007."},{"key":"e_1_2_11_16_1","unstructured":"\u201cEvidence\u2010Based Clinical Practice Guidelines for Chronic Pancreatitis 2021 (3rd Edition) From the Japanese Society of Gastroenterology [in Japanese] \u201dhttps:\/\/www.jsge.or.jp\/committees\/guideline\/guideline\/pdf\/manseisuien_2021.pdf."},{"key":"e_1_2_11_17_1","first-page":"279","article-title":"Clinical Diagnostic Criteria for Chronic Pancreatitis 2019 [in Japanese]","volume":"34","author":"Japan Pancreas Society","year":"2019","journal-title":"Journal of Japan Pancreas Society (Suizou)"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s40801-022-00296-5","article-title":"Context and Considerations for Use of Two Japanese Real\u2010World Databases in Japan: Medical Data Vision and Japanese Medical Data Center","volume":"9","author":"Laurent T.","year":"2022","journal-title":"Drugs \u2010 Real World Outcome"},{"key":"e_1_2_11_19_1","unstructured":"Medical Data Vision \u201cMDV EBM Insight \u201dhttps:\/\/en.mdv.co.jp\/ebm\/about\u2010mdv\u2010database\/mdv\u2010database\u2010overview\/."},{"key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1001\/archinternmed.2008.601","article-title":"Smoking and Risk of Acute and Chronic Pancreatitis Among Women and Men: A Population\u2010Based Cohort Study","volume":"169","author":"Tolstrup J. S.","year":"2009","journal-title":"Archives of Internal Medicine"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/BF01211379","article-title":"Steatorrhea in Japanese Patients With Chronic Pancreatitis","volume":"30","author":"Nakamura T.","year":"1995","journal-title":"Journal of Gastroenterology"}],"container-title":["JGH Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.70473","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jgh3.70473","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.70473","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:56:25Z","timestamp":1790751385000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgh3.70473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":20,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/jgh3.70473"],"URL":"https:\/\/doi.org\/10.1002\/jgh3.70473","archive":["Portico"],"relation":{},"ISSN":["2397-9070","2397-9070"],"issn-type":[{"value":"2397-9070","type":"print"},{"value":"2397-9070","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2026-05-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70473"}}