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Enrique de-Madaria (born October 20, 1975, in Alicante, Spain), is a renowned gastroenterologist and researcher specializing in pancreatic and biliary diseases.[1] His primary research focus is acute pancreatitis, particularly early-phase fluid therapy, where his studies have significantly influenced clinical practice. He is also the founder of the "Race of the Cities Against Pancreatic Cancer," an international sporting event that has raised over a million euros for pancreatic cancer research.[2]
Biography Enrique de-Madaria (Enrique de Madaria Pascual) was born in Alicante, Spain, in 1975. He studied medicine at the Miguel Hernández University of Elche, completed his residency in gastroenterology from 2000 to 2004 at the Hospital General Universitario de Alicante (currently known as Hospital General Universitario Dr. Balmis), and earned his PhD in 2009 from the same university. Since 2004, he has headed the Biliopancreatic Unit at the Hospital General Universitario Dr. Balmis. He has been an associate professor in the Department of Clinical Medicine at the Miguel Hernández University of Elche since 2020.[3]
Research Contributions Enrique de-Madaria has made significant advancements in the field of fluid therapy for acute pancreatitis. Since the late 1990s, aggressive intravenous fluid therapy was recommended for patients with acute pancreatitis, with the belief that resultant hemodilution would ensure adequate blood flow to the pancreas, preventing glandular necrosis and improving prognosis.[4]
In 2011, he published a prospective observational study indicating that patients receiving aggressive fluid therapy had a worse disease course.[5] In 2018, he conducted a single-center randomized clinical trial demonstrating that lactated Ringer's solution had anti-inflammatory properties in acute pancreatitis.[6]
In 2022, he published the results of the WATERFALL randomized controlled trial in the New England Journal of Medicine.[7] This study compared aggressive versus moderate fluid therapy in 249 patients across 18 centers in four countries, showing that aggressive fluid therapy was unsafe and associated with a threefold increase in cardiopulmonary overload events. The study was recognized as one of the top ten gastroenterology articles of 2022 by Medscape [8] and among the top ten clinical stories of 2022 by the New England Journal of Medicine.[9] The findings influenced the 2024 American College of Gastroenterology guidelines to recommend moderate fluid therapy for acute pancreatitis based on this research.[10]
Additionally, Enrique de-Madaria and his collaborators developed the PAN-PROMISE, a Patient Reported Outcome Measurement tool that assesses the main symptoms of acute pancreatitis. This scale was validated in an international study and is a useful tool for exploring the subjective experiences of patients with acute pancreatitis.[11]
Roles in Scientific Societies Enrique de-Madaria founded and served as the first president of the Spanish Pancreatology Association (AESPANC) from 2013 to 2016. He was also president of the Spanish Association of Gastroenterology from 2020 to 2023.[12]
Race of the Cities Against Pancreatic Cancer In January 2015, Enrique de-Madaria organized a charity run between the towns of Mutxamel and Sant Joan in Alicante, on behalf of the Spanish Association of Pancreatology (AESPANC), to raise awareness about the high mortality rate of pancreatic cancer and to fund research.[13] That same year, additional events took place in Alicante and Las Rozas, Madrid, in collaboration with the patient association ACANPAN. Since 2015, the event has expanded to 14 cities in Spain, attracting over 60,000 participants and raising more than one million euros for pancreatic cancer research.[14]
Awards Miguel Pérez Mateo Research Award in Gastroenterology (2016)[15] United European Gastroenterology (UEG) Rising Star Award (2017)[16][17] TopDoctors Top 50 Best Doctors in Spain (2023)[18] United European Gastroenterology (UEG) Research Prize (2024) – Enrique de-Madaria was the first Spaniard and pancreatologist to receive this award[19]