{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:05:59Z","timestamp":1789182359061,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"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":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with acute pancreatitis (AP) often experience recurrent acute pancreatitis (RAP), increasing the risk of chronic pancreatitis (CP) and long\u2010term complications. Progression along the AP\u2013RAP\u2013CP spectrum has been explored in epidemiological studies, but available data provide limited insight into recurrence dynamics within RAP itself. This information is crucial for the design of studies aiming to prevent RAP recurrence and disease progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this nationwide cohort study, we included 45,338 Danish adults hospitalised with an incident episode of AP between January 1, 2000, and December 31, 2022, identified through national health registries. RAP was defined as recurrent hospitalisations for AP separated by \u2265\u200990\u2009days. Competing risk models with pseudo\u2010observations estimated cumulative incidence functions for RAP recurrence stratified by the number of prior AP episodes. Inter\u2010episode intervals were estimated using Weibull models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow\u2010up of 4.5\u2009years, 6894 patients developed RAP, corresponding to a 15.2% risk (95% confidence interval, 14.9%\u201315.5%). The RAP recurrence risk increased with accumulating episodes. The 12\u2010month cumulative incidence of RAP recurrence rose from 17% after one RAP episode to 46% after five episodes. Most recurrences occurred within 12\u2009months, and inter\u2010episode intervals shortened with increasing episode number. Weibull models demonstrated a wear\u2010out pattern, with shape parameters increasing progressively across successive RAP episodes, indicating accelerating recurrence risk over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RAP follows an accelerating course characterised by increasing recurrence risk. Risk\u2010enriched trial designs targeting patients with more prior episodes may improve the feasibility and statistical efficiency of future interventional studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70820","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T03:36:24Z","timestamp":1782444984000},"page":"976-984","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Natural History of Recurrent Acute Pancreatitis: Implications for Interventional Trial Design"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3916-3168","authenticated-orcid":false,"given":"S\u00f8ren S.","family":"Olesen","sequence":"first","affiliation":[{"name":"Centre for Pancreatic Diseases and Mech\u2010Sense, Department of Gastroenterology and Hepatology Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels Henrik","family":"Bruun","sequence":"additional","affiliation":[{"name":"Research Data and Biostatistics Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1120-8144","authenticated-orcid":false,"given":"Line","family":"Davidsen","sequence":"additional","affiliation":[{"name":"Centre for Pancreatic Diseases and Mech\u2010Sense, Department of Gastroenterology and Hepatology Aalborg University Hospital  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srdan","family":"Novovic","sequence":"additional","affiliation":[{"name":"Pancreatitis Centre East, Gastro Unit Copenhagen University Hospital Hvidovre  Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stig B.","family":"Laursen","sequence":"additional","affiliation":[{"name":"Department of Medical Gastroenterology Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2412-9541","authenticated-orcid":false,"given":"Enrique","family":"de\u2010Madaria","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Dr. Balmis General University Hospital\u2010ISABIAL  Alicante Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) \u2010 Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhiraj","family":"Yadav","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7465-964X","authenticated-orcid":false,"given":"Asbj\u00f8rn M.","family":"Drewes","sequence":"additional","affiliation":[{"name":"Centre for Pancreatic Diseases and Mech\u2010Sense, Department of Gastroenterology and Hepatology Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2024.12.029"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575\u2010018\u20100087\u20105"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)31310\u20106"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2025.2485135"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000001122"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.12.040"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.07.066"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.12.033"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2014.09.009"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.213835"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.23988"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102025\u2010337154"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.70178"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.126"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.08.042"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810394717"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2022.07.079"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21\u20100333"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1501500313"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/0471725234"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2016.02.001"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.06.013"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494818773535"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2023.12.011"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001469"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S133624"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.70820","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apt.70820","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.70820","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:28:18Z","timestamp":1789180098000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.70820"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":28,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/apt.70820"],"URL":"https:\/\/doi.org\/10.1111\/apt.70820","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"assertion":[{"value":"2026-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}