C. Roberto Simons-Linares, MD, MSc: Disparity in Pancreatic Enzyme Replacement Therapy

While exocrine pancreatic insufficiency is a common complication of pancreatic cancer, pancreatic enzyme replacement therapy (PERT) can be used to prevent malnutrition, morbidity, and mortality.

However, in data presented by Cleveland Clinic doctors at the annual American College of Gastroenterology (ACG) 2020 conference shows that African American patients are far less likely to receive this type of therapy.

In the study, the researchers used a commercial database to identify a cohort of patients with a Systematized Nomenclature of Medicine-Clinical Terms diagnosis of pancreatic cancer.

From there, they identified patients who were prescribed PERT following the diagnosis and performed a case control study to compare the outcomes of patients with and without PERT.

After conducting this review, the investigators found a lack of PERT prescriptions was disproportionally found in older patients, as well as African American patients.

On the other hand, patients with comorbid conditions known to be associated with exocrine pancreatic insufficiency such as chronic pancreatitis, malnutrition, bariatric surgery, and vitamin D deficiency were more likely to be prescribed PERT.

Ultimately, the research team suggests strategies need to be implemented to improve the gaps in treatment and address some of the health care disparities found in the study.

In an interview with HCPLive®, C. Roberto Simons-Linares, MD, MSc, Cleveland Clinic, explained some of the reasons why this discrepancy might exist.