Oral Presentation The Pancreas Summit 2025

A Multinational Study on Chronic Pancreatitis in Southeast and South Asia (CPSEASA) (125724)

Misbah Unnisa 1 , Abdul Rasheed 1 , Rajesh Goud 1 , Archi Patel 2 , Soumya Javvaji 1 , Madhurya Reddy 1 , Rajiv Mehta 2 , Gajanan Rodge 3 , Sandip Pal 4 , Soumya Jagannath 5 , Shallu Midha 5 , Divya Pillai 5 , Kshaunish Das 6 , Kalidas Biswas 7 , Bipadabhanjan Mallick 8 , Masudur Rahaman 9 , Sofidul Islam 9 , Rajib Datta 9 , Tin Moe Wai 10 , Than Than Aye 10 , Justin Young Yeh Lee 11 , Vincent Tee 11 , Rahul Pathak 12 , Supot Pongprasobchai 13 , Nilesh Fernandopulle 14 , Duminda Subasinghe 14 , Hasitha Wijewantha 14 , Pramod Garg 5 , Duvvur Nageshwar Reddy 1 , Rupjyoti Talukdar 1
  1. Asian Institute of Gastroenterology (AIG) Hospitals, Hyderabad, TELANGANA, India
  2. SIDS Hospital and Research Centre, Surat, Gujarat, India
  3. Bombay Hospital, Bombay, Maharashtra, India
  4. Rabindranath Tagore Hospital, Kolkata, West Bengal, India
  5. All India Institute of Medical Sciences, Delhi, India
  6. Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal, India
  7. Medical College Kolkata, Kolkata, West Bengal, India
  8. Lisie Hospital Ernakulam, Bhubaneswar, Odisa, India
  9. Sheikh Russel Gastro Liver Institute and Hospital, Dhaka, Bangladesh
  10. Yangon General Hospital, Yangon, Myanmar
  11. Universiti Sains Malaysia, Malaysia , Minden, Malaysia
  12. Tribhuvan University Teaching Hospital, Kirtipur, Kathmandu, Nepal
  13. Siriraj Hospital, Bangkok, Thailand
  14. National Hospital of Sri Lanka, Colombo, Sri Lanka

Background

Chronic pancreatitis (CP) is a multifactorial disease. While alcohol and smoking are predominant causes in Western populations (1), idiopathic CP is more frequently reported in parts of Asia (2). However, large-scale, multicentre data from Southeast Asia remains limited. The aim of this study was to develop a Chronic Pancreatitis in South-East and South Asia (CPSEASA) database to evaluate the clinical behaviour, disease morphology, and treatment response of CP in South and Southeast Asia.

Methods

This cross-sectional, multinational, prospective, observational study enrolled 1,806 patients with confirmed CP from July 2020 to January 2025. Recruitment was conducted across India (8 centers), with one center each from Bangladesh, Myanmar, Nepal, Thailand, Malaysia, and Sri Lanka. Data were collected using a standardized proforma that included demographics, risk factors, pain characteristics, imaging findings, treatments, and short-term outcomes. Continuous variables were presented as mean ± standard deviation (SD), and categorical variables as proportions.

Results

In the overall study population, the mean age was 37.4 ± 13.8 years, with males comprising 70.8% (n=1280). Idiopathic chronic pancreatitis (CP) was the most common etiology (59.8%), followed by alcohol-related (30.1%) and smoking-associated (24%). The mean disease duration was 40 months, and 33.5% experienced acute exacerbations. Painful CP was present in 84.6%, with a mean maximum VAS score of 7.15 ± 3.02. Episodic pain was the most frequent pattern (31.9%), and 15.7% reported a change in pain character over time. Common symptoms included weight loss (64.5%) and bone pain (20.1%). Morphologically, main pancreatic duct dilatation (76.4%) and parenchymal calcifications (58%) were the most prevalent abnormalities. Most (58.6%) followed a regular home-cooked diet with frequent fat restriction. Regarding treatment, 71.1% used pancreatic enzyme replacement therapy (PERT), 21% received neuromodulators, and 36.7% underwent endotherapy. While 41.2% reported short-term (3–6 months) pain relief, 57.9% experienced pain relapse after initial treatment.

Conclusion

CPSEASA is the first multinational study to comprehensively characterize chronic pancreatitis across Southeast Asia, revealing distinct epidemiological patterns unique to this region. These insights emphasize the need for region-specific diagnostic approaches and therapeutic strategies to better manage CP in Asian populations.

  1. Yadav D, Hawes RH, Brand RE, et al. Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis. Arch Intern Med. 2009;169(11):1035-1045. doi: 10.1001/archinternmed.2009.125.
  2. Garg PK. Chronic pancreatitis in India and Asia. Curr Gastroenterol Rep. 2012 Apr;14(2):118-24. doi: 10.1007/s11894-012-0241-0. PMID: 22327961.