Meta-analysis: allopurinol in the prevention of postendoscopic retrograde cholangiopancreatography pancreatitis

Alimentary Pharmacology & Therapeutics
Y BaiZ Li

Abstract

Several clinical trials evaluating the prophylactic effect of allopurinol on postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis have been published; however, there is no consensus on whether prophylactic allopurinol can reduce the incidence of post-ERCP pancreatitis. To compare prophylactic allopurinol with placebo on post-ERCP pancreatitis reduction by performing a meta-analysis in randomized controlled trials. Databases including MEDLINE, EMBASE and the Cochrane Library, Science Citation Index were searched to find relevant trials. Two reviewers independently identified relevant randomized controlled trials assessing the effect of prophylactic allopurinol on the incidence of post-ERCP pancreatitis. Outcome measures were the incidence of post-ERCP pancreatitis. Four trials involving 1730 patients were included. Analysis suggested that post-ERCP pancreatitis rates were not significantly different (allopurinol 8.9%, placebo 9.7%, P = 0.68), RR 0.86 (95% CI: 0.42, 1.77). Subsequent subgroup analysis confirmed that allopurinol was not statistically superior to placebo in reducing post-ERCP pancreatitis. Based on current best evidence, prophylactic allopurinol may not be useful for post-ERCP pancreatitis reduction.

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Citations

Apr 3, 2009·World Journal of Gastroenterology : WJG·Hector Martinez-TorresAlejandro Gonzalez-Ojeda
Apr 25, 2013·Journal of Gastroenterology·Takero MazakiMotomi Shiono
Jan 23, 2009·Digestive Diseases and Sciences·Li-Ming ShaoJian-Ting Cai
Oct 22, 2013·Alimentary Pharmacology & Therapeutics·V S AkshintalaV K Singh
Dec 17, 2009·Journal of Hepato-biliary-pancreatic Sciences·Shinju ArataMasao Tanaka
Jan 4, 2019·Journal of Digestive Diseases·Yu BaiUNKNOWN Chinese Digestive Endoscopist Committee, Chinese Endoscopist Association; Chinese Physicians' Association; Pancreatic Diseas
Nov 15, 2020·Current Gastroenterology Reports·Nikhil R Thiruvengadam, Michael L Kochman

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