• Patients 18 - 85 years of age

• Two or more documented attacks of acute pancreatitis, separated by 3 months from one another, defined by at least 2 of the following 3:

‣ amylase or lipase values, or both, that are greater than 3 times the upper limit of normal values

⁃ characteristic cross-sectional imaging

⁃ typical upper abdominal pain according to the revised Atlanta classification28

• Drug/placebo treatment to start

‣ Mild AP Patient is discharged out of the hospital 30 days after diagnosis of mild AP

⁃ Moderate Severe or Severe AP Patient is discharged out of hospital Intra-abdominal collections are either resolved on imaging, or are improving and asymptomatic (VAS Pain score ≤3 \[with or without pain medication\], vomiting ≤once a week, tolerating light diet, and no fever and chills) and do not warrant any intervention (per treating physician)

• Ability to understand and the willingness to sign a written informed consent document and medical release

• Willing and able to comply with trial protocol and follow up

• 2nd AP episode despite correction of the AP etiology (if identified) after the 1st episode as follows i. Patients with biliary pancreatitis who have undergone cholecystectomy, with or without ERCP (if indicated) ii. Patients with hypertriglyceridemia induced pancreatitis who have serum triglyceride levels below 400 while on medication management iii. Patients with medication induced AP developing a 2nd AP episode despite stopping the culprit medication