{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T19:58:54Z","timestamp":1780084734340,"version":"3.54.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Dig Dis Sci"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The role of naltrexone in improving acute alcoholic pancreatitis (AAP) outcomes in alcohol use disorder (AUD) patients, remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We aimed to assess the temporal trends in AAP incidence and the impact of naltrexone use on clinical outcomes in AUD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using de-identified patient data from the TriNetX database, including all adults (\u2265\u200918\u00a0years) diagnosed with AUD. AAP patients were then identified and stratified by naltrexone exposure. The incidence and prevalence of AAP in AUD patients were assessed pre-(March 2015\u20132019) and post-COVID-19(March 2020\u20132025). Propensity score matching (PSM) (1:1) was performed to adjust for confounders. Univariate Cox proportional hazards model was used to assess the outcomes including mortality, chronic pancreatitis, alcoholic hepatitis, cirrhosis, hospital readmission, and emergency department (ED) visits at 1, 6, and 12\u00a0months. Standardized mean differences\u2009&lt;\u20090.1 ensured well-matched cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1,331,338 AUD adults, 33,561 (2.52%) developed AAP. The incidence of AAPs increased significantly following the COVID-19 pandemic, with the largest relative rise among younger adults (18\u201334\u00a0years), women, and racial minorities. Of those with AAP, 1,871(5.6%) received naltrexone. Following PSM, naltrexone use was associated with significantly lower odds of mortality at one (OR 0.274,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and six months (OR 0.571,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Reduced odds were also observed for alcoholic hepatitis at one month and hospital readmissions across all time points. Surprisingly, naltrexone use was associated with increased odds of ED visits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The incidence of AAP has increased since COVID-19 onset. Naltrexone may improve short-term outcomes in patients with AUD and AAP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10620-025-09411-2","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T17:43:54Z","timestamp":1759167834000},"page":"880-888","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trends and Outcomes of Alcoholic Acute Pancreatitis in Patients with Alcohol Use Disorder Treated with Naltrexone in the United States: Before and After the COVID-19 Pandemic"],"prefix":"10.1007","volume":"71","author":[{"given":"Thai Hau","family":"Koo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Malik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Zaahid","family":"Sheriff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Chowdhary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Lindsey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"9411_CR1","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1186\/s12876-015-0323-1","volume":"15","author":"JH Cho","year":"2015","unstructured":"Cho JH, Kim TN, Kim SB. Comparison of clinical course and outcome of acute pancreatitis according to the two main etiologies: Alcohol and gallstone. BMC Gastroenterol 2015;15:87. https:\/\/doi.org\/10.1186\/s12876-015-0323-1.","journal-title":"BMC Gastroenterol"},{"key":"9411_CR2","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.ijsu.2015.07.701","volume":"23","author":"M Nesvaderani","year":"2015","unstructured":"Nesvaderani M, Eslick GD, Vagg D, Faraj S, Cox MR. Epidemiology, aetiology and outcomes of acute pancreatitis: A retrospective cohort study. Int J Surg 2015;23:68\u201374. https:\/\/doi.org\/10.1016\/j.ijsu.2015.07.701.","journal-title":"Int J Surg"},{"key":"9411_CR3","doi-asserted-by":"publisher","unstructured":"Alcohol-induced Death Rates in the United States, 2019\u20132020. CDC: Centers for Disease Control and Prevention 2022. https:\/\/doi.org\/10.15620\/cdc:121795","DOI":"10.15620\/cdc:121795"},{"key":"9411_CR4","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1001\/jama.2023.19761","volume":"330","author":"M McPheeters","year":"2023","unstructured":"McPheeters M, O\u2019Connor EA, Riley S, Kennedy SM, Voisin C, Kuznacic K et al. Pharmacotherapy for alcohol use disorder: A systematic review and meta-analysis. Jama 2023;330:1653\u20131665. https:\/\/doi.org\/10.1001\/jama.2023.19761.","journal-title":"Jama"},{"key":"9411_CR5","volume-title":"Treatment of alcohol use disorder","author":"Y Mar","year":"2023","unstructured":"Mar Y, Whitley SD, Weigand TJ, Stancliff SL, Gonzalez CJ, Hoffmann CJ. Treatment of alcohol use disorder. Baltimore: Johns Hopkins University; 2023."},{"key":"9411_CR6","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1002\/hep.30866","volume":"71","author":"DW Crabb","year":"2020","unstructured":"Crabb DW, Im GY, Szabo G, Mellinger JL, Lucey MR. Diagnosis and treatment of alcohol-associated liver diseases: 2019 Practice Guidance From the American Association for the Study of Liver Diseases. Hepatology 2020;71:306\u2013333. https:\/\/doi.org\/10.1002\/hep.30866.","journal-title":"Hepatology"},{"key":"9411_CR7","doi-asserted-by":"publisher","first-page":"S1078","DOI":"10.14309\/01.ajg.0000955292.97711.40","volume":"118","author":"AK Malik","year":"2023","unstructured":"Malik AK, Niu B, Singh AD. S1413 naltrexone after hospitalization for patients with alcohol use disorder and alcohol-associated liver disease reduces risks of hepatic decompensation and mortality. Am J Gastroenterol 2023;118:S1078. https:\/\/doi.org\/10.14309\/01.ajg.0000955292.97711.40.","journal-title":"Am J Gastroenterol"},{"key":"9411_CR8","doi-asserted-by":"publisher","first-page":"553","DOI":"10.3390\/gastroent14040039","volume":"14","author":"M Cevolani","year":"2023","unstructured":"Cevolani M, Ferronato M, Lizzio CE, Elia E, Marini D, Mazzotta E et al. COVID-19 and acute pancreatitis: Not increased risk but reduced care. Gastroenterol Insights 2023;14:553\u2013563.","journal-title":"Gastroenterol Insights"},{"key":"9411_CR9","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000093","volume":"7","author":"A Rabiee","year":"2023","unstructured":"Rabiee A, Mahmud N, Falker C, Garcia-Tsao G, Taddei T, Kaplan DE. Medications for alcohol use disorder improve survival in patients with hazardous drinking and alcohol-associated cirrhosis. Hepatol Commun 2023;7:e0093. https:\/\/doi.org\/10.1097\/HC9.0000000000000093.","journal-title":"Hepatol Commun"},{"key":"9411_CR10","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1097\/00004714-200002000-00012","volume":"20","author":"SS O'Malley","year":"2000","unstructured":"O\u2019Malley SS, Krishnan-Sarin S, Farren C, O\u2019Connor PG. Naltrexone-induced nausea in patients treated for alcohol dependence: clinical predictors and evidence for opioid-mediated effects. J Clin Psychopharmacol 2000;20:69\u201376. https:\/\/doi.org\/10.1097\/00004714-200002000-00012.","journal-title":"J Clin Psychopharmacol"}],"container-title":["Digestive Diseases and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-025-09411-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10620-025-09411-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-025-09411-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T05:10:50Z","timestamp":1773292250000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10620-025-09411-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,29]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["9411"],"URL":"https:\/\/doi.org\/10.1007\/s10620-025-09411-2","relation":{},"ISSN":["0163-2116","1573-2568"],"issn-type":[{"value":"0163-2116","type":"print"},{"value":"1573-2568","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,29]]},"assertion":[{"value":"11 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This is an observational study. The MetroHealth Medical Center Research Ethics Committee has confirmed that no ethical approval is required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Patient consent was not required for this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Patient consent was not required for this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}