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 22 February 2018

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News

NSAIDs in the prevention of post-ERCP pancreatitis

Prophylactic NSAIDs are effective in preventing post-ERCP pancreatitis, suggests a meta-analysis in the latest issue of Gut.

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Several pharmacological agents for the prevention of post-ERCP pancreatitis have been studied.

Clinical trials evaluating the protective effect of non-steroidal anti-inflammatory drugs (NSAIDs) have been inconclusive.

In this study, Dr Elmunzer and colleagues conducted a meta-analysis evaluating the effect of prophylactic rectal NSAIDs on post-ERCP pancreatitis.

64% were less likely to develop pancreatitis.
Gut

The team identified suitable randomized controlled trial by searching Medline, Embase, meeting abstracts and bibliographies.

The research team found 4 suitable trials, enrolling a total of 912 patients.

A meta-analysis of these studies demonstrated a pooled relative risk for post-ERCP pancreatitis after prophylactic administration of NSAIDs of 0.36.

Patients who received NSAIDs in the periprocedural period were 64% less likely to develop pancreatitis and 90% less likely to develop moderate to severe pancreatitis.

The team found that the pooled number needed to treat with NSAIDs to prevent one episode of pancreatitis is 15 patients.

They did not identify any adverse events attributable to the use of NSAIDs in any of the clinical trials.

Dr Elmunzer's team concluded, “In this meta-analysis, prophylactic NSAIDs were effective in preventing post-ERCP pancreatitis”.

“Widespread prophylactic administration of these agents may significantly reduce the incidence of post-ERCP pancreatitis, resulting in major clinical and economic benefit.”

“Given current scepticism regarding the efficacy of any prophylactic medication for ERCP, additional multicentre studies are needed for confirmation prior to widespread adoption of this strategy.”

Gut 2008; 57: 1262-7

05 September 2008

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