Prevention of Severe Acute Pancreatitis With Cyclooxygenase-2 Inhibitors: A Randomized Controlled Clinical Trial

The American Journal of Gastroenterology
Zhiyin HuangLibin Huang

Abstract

Severe acute pancreatitis (SAP) is still a big challenge. Accumulated data showed that overexpression of cyclooxygenase-2 (COX-2) in acute pancreatitis and experimental pancreatitis could be attenuated with COX-2 inhibitors. This study was aimed to evaluate whether the occurrence of SAP could be prevented by selective COX-2 inhibitors. A total of 190 patients with predicted SAP were randomized into convention group or convention plus COX-2 inhibitors (C+COX-2-Is) group. Besides conventional treatment to all patients in 2 groups, parecoxib (40 mg/d intravenous injection for 3 days) and celecoxib (200 mg oral or tube feeding twice daily for 7 days) were sequentially administrated to the patients in the C+COX-2-Is group. The primary outcome was predefined as the occurrence of SAP. The serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) for all of the patients were measured. The occurrence of SAP in the C+COX-2-Is group was decreased 47.08% compared with the convention group, 21.05% (20/95) vs 39.78% (37/93), P = 0.005. A reduction of late local complications was also shown in the C+COX-2-Is group, 18.95% (18/93) vs 34.41% (32/95), P = 0.016. The serum levels of IL-6 and TNF-α were significantly lower in the C+...Continue Reading

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Citations

Jul 31, 2020·Clinical & Translational Immunology·Sean Wei Xiang OngBarnaby Edward Young
Sep 5, 2020·The American Journal of Gastroenterology·Soumya Jagannath Mahapatra, Pramod Garg
Nov 25, 2020·Current Treatment Options in Gastroenterology·Peter J Lee, Georgios I Papachristou
Sep 15, 2020·International Journal of Surgery Case Reports·Yayun XuZiping Zhang
Jul 18, 2021·The Journal of Pediatrics·Peter R FarrellMaisam Abu-El-Haija
Aug 27, 2021·BMC Gastroenterology·Meng WangHongyin Liang
Oct 28, 2021·Clinical and Translational Gastroenterology·Jorge D MachicadoGeorgios I Papachristou

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