The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the prevention of post-ERCP pancreatitis (PEP) is still controversial.
Dr Xiwei Ding and colleagues performed a meta-analysis evaluated the efficacy and safety of NSAIDs for PEP prophylaxis.
The research team systematically searched PubMed, EMBASE, Web of Science, and the Cochrane Library for relevant studies published updated to 2012.
The studies evaluated patients undergoing ERCPs with NSAIDs use for the prevention of PEP.
The team's main outcome measurements investigated overall incidence of PEP, incidence of moderate to severe PEP, and adverse events.
|The absolute risk reduction was 6% for overall incidence of PEP|
The researchers identified 10 randomized controlled trials involving 2269 patients.
The team showed that NSAID use decreased the overall incidence of PEP, with an absolute risk reduction of 6%.
The number needed to treat was 17.
Heterogeneity among the studies was substantial.
However, after removing the main source of heterogeneity, the prophylactic efficacy was similar.
NSAID use also decreased the incidence of moderate to severe PEP.
The team found that the absolute risk reduction was 3%.
The number needed to treat was 34.
The research team observed no differences of the adverse events attributable to NSAIDs.
Inclusion of low-quality studies, different type and route of administration of the NSAIDs, study heterogeneity, inconsistent use of pancreatic stenting.
Dr Ding's team concludes, "Prophylactic use of NSAIDs reduces the incidence and severity of PEP."