# Targeted Drug Delivery for the Treatment of Abdominal Pain in Chronic Pancreatitis: A Retrospective Case Series

## TL;DR

This study shows that targeted drug delivery reduces opioid use and improves pain control in patients with chronic pancreatitis.

## Contribution

The paper presents a novel application of targeted drug delivery for managing chronic pain in chronic pancreatitis patients.

## Key findings

- Targeted drug delivery significantly reduced morphine-equivalent doses compared to oral opioid therapy.
- Patients experienced improved pain scores following targeted drug delivery implantation.
- Pain scores decreased from an average of 6.5/10 to 4.9/10 within three months of treatment.

## Abstract

Summary: Abdominal pain secondary to chronic pancreatitis (CP) is difficult to manage and often requires chronic oral opioid therapy (OOT). Targeted drug delivery (TDD) allows for a diminished dose of opioid intake and improved pain levels. TDD has been used in different pain syndromes with only limited reports in CP.

Objective: The objective of this article is to perform a retrospective review of CP patients treated with TDD versus OOT to compare chronic pain control and consumed morphine-equivalent doses.

Methods: Patients receiving TDD between September 2011 and August 2018 were included. All patients were weaned off oral opioids one week before intrathecal trial and pump implantation. Patients with intrathecal trials providing at least 50% pain relief underwent pump implantation. Data were collected while on OOT and at two weeks, three months, and nine months post-implant. Data were analyzed with Microsoft Excel 365 MSO using means and standard deviations. P-values were calculated using a two-tailed student’s t-test with paired two-sample means.

Results: Twenty-three patients were analyzed. Pre-trial average pain score was 6.5/10 with a mean improvement with trials greater than 71%. The mean chronic baseline oral morphine milligram equivalents (MME) was 188. The mean MME on TDD at two weeks (0.36), three months (1.39), and nine months (2.47) were significantly lower than OOT. Mean pain scores were 6, 4.9, and 5.6 at two weeks, three months, and nine months, respectively, compared to 6.5 on OOT.

Discussion: The results of this study indicate that TDD provides improved pain control with significantly lower opioid doses.