Muhammad S Sajid1, Amir H Khawaja1, Mazin Sayegh1, Krishna K Singh1, Zinu Philipose1. 1. Muhammad S Sajid, Amir H Khawaja, Department of General, Endoscopic and Laparoscopic Colorectal Surgery, Western Sussex Hospitals NHS Foundation Trust Worthing Hospital Worthing, West Sussex BN11 2DH, United Kingdom.
Abstract
AIM: To critically appraise the published randomized, controlled trials on the prophylactic effectiveness of the non-steroidal anti-inflammatory drugs (NSAIDs), in reducing the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. METHODS: A systematic literature search (MEDLINE, Embase and the Cochrane Library, from inception of the databases until May 2015) was conducted to identify randomized, clinical trials investigating the role of NSAIDs in reducing the risk of post-ERCP pancreatitis. Random effects model of the meta-analysis was carried out, and results were presented as odds ratios (OR) with corresponding 95%CI. RESULTS: Thirteen randomized controlled trials on 3378 patients were included in the final meta-analysis. There were 1718 patients in the NSAIDs group and 1660 patients in non-NSAIDs group undergoing ERCP. The use of NSAIDs (through rectal route or intramuscular route) was associated with the reduced risk of post-ERCP pancreatitis [OR, 0.52 (0.38-0.72), P = 0.0001]. The use of pre-procedure NSAIDs was effective in reducing approximately 48% incidence of post-ERCP pancreatitis, number needed to treat were 16 with absolute risk reduction of 0.05. But the risk of post-ERCP pancreattis was reduced by 55% if NSAIDs were administered after procedure. Similarly, diclofenac was more effective (55%) prophylactic agent compared to indomethacin (41%). CONCLUSION: NSAIDs seem to have clinically proven advantage of reducing the risk of post-ERCP pancreatitis.
AIM: To critically appraise the published randomized, controlled trials on the prophylactic effectiveness of the non-steroidal anti-inflammatory drugs (NSAIDs), in reducing the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. METHODS: A systematic literature search (MEDLINE, Embase and the Cochrane Library, from inception of the databases until May 2015) was conducted to identify randomized, clinical trials investigating the role of NSAIDs in reducing the risk of post-ERCP pancreatitis. Random effects model of the meta-analysis was carried out, and results were presented as odds ratios (OR) with corresponding 95%CI. RESULTS: Thirteen randomized controlled trials on 3378 patients were included in the final meta-analysis. There were 1718 patients in the NSAIDs group and 1660 patients in non-NSAIDs group undergoing ERCP. The use of NSAIDs (through rectal route or intramuscular route) was associated with the reduced risk of post-ERCP pancreatitis [OR, 0.52 (0.38-0.72), P = 0.0001]. The use of pre-procedure NSAIDs was effective in reducing approximately 48% incidence of post-ERCP pancreatitis, number needed to treat were 16 with absolute risk reduction of 0.05. But the risk of post-ERCP pancreattis was reduced by 55% if NSAIDs were administered after procedure. Similarly, diclofenac was more effective (55%) prophylactic agent compared to indomethacin (41%). CONCLUSION: NSAIDs seem to have clinically proven advantage of reducing the risk of post-ERCP pancreatitis.
Authors: M Yaghoobi; S Rolland; K A Waschke; J McNabb-Baltar; M Martel; R Bijarchi; P Szego; A N Barkun Journal: Aliment Pharmacol Ther Date: 2013-09-16 Impact factor: 8.171
Authors: Zoltán Döbrönte; Zoltán Szepes; Ferenc Izbéki; Judit Gervain; László Lakatos; Gyula Pécsi; Miklós Ihász; Lilla Lakner; Erzsébet Toldy; László Czakó Journal: World J Gastroenterol Date: 2014-08-07 Impact factor: 5.742
Authors: Ali Akbar; Barham K Abu Dayyeh; Todd H Baron; Zhen Wang; Osama Altayar; Mohammad Hassan Murad Journal: Clin Gastroenterol Hepatol Date: 2013-01-30 Impact factor: 11.382
Authors: Giovanna Sheiybani; Peter Brydon; Miriam Toolan; John Linehan; Mark Farrant; Benjamin Colleypriest Journal: Frontline Gastroenterol Date: 2017-08-10
Authors: Juan Pablo Román Serrano; José Jukemura; Samuel Galante Romanini; Paúl Fernando Guamán Aguilar; Juliana Silveira Lima de Castro; Isabela Trindade Torres; José Andres Sanchez Pulla; Otavio Micelli Neto; Eloy Taglieri; José Celso Ardengh Journal: World J Gastrointest Endosc Date: 2020-11-16