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Acute pancreatitis (AP) is one of the main reasons for hospitalization of patients in gastrointestinal emergency departments.
The global incidence of AP is about 34/100,000
.
Although most patients with AP have mild clinical symptoms, 10%–15% of patients will develop severe AP (SAP) with persistent organ failure (OF), and about 2% of patients will die
Acute pancreatitis (AP) is one of the main reasons for hospitalization of patients in gastrointestinal emergency departments.
Non-steroidal anti-inflammatory drugs (NSAIDs) are effective inhibitors of COX enzymes, which can prevent the biosynthesis of prostaglandins and reduce the inflammatory response of AP
.
In view of the effectiveness, safety, availability, and affordability of non-selective NSAIDs, they are often used to prevent pancreatitis after endoscopic retrograde cholangiopancreatography
This study is a single-center, double-blind, randomized, placebo-controlled trial
.
The included patients were those who had AP and SIRS within 72 hours after presentation, and those who did not have organ failure
The results of the study showed that a total of 42 subjects (mean age 52 years, 55% male) were randomly assigned to the indomethacin group (n = 18) or placebo group (n = 24)
.
There were no significant differences between the indomethacin group and the placebo group in terms of changes in SIRS scores, the proportion of SIRS subjects, and the distribution of SIRS scores at 24, 48, and 72 hours after randomization
This study confirms that rectal indomethacin can be safely administered within 48 hours; however, it is not superior to placebo in reducing SIRS or clinical progression in people at high risk of AP
.
Therefore, the treatment of rectal indomethacin is not recommended for all patients who are not contraindicated with non-steroidal anti-inflammatory drugs and are at risk of postoperative pancreatitis
This study confirms that rectal indomethacin can be safely administered within 48 hours; however, it is not superior to placebo in reducing SIRS or clinical progression in people at high risk of AP
Original source:
Machicado, Jorge D.
Rectal Indomethacin Does Not Mitigate the Systemic Inflammatory Response Syndrome in Acute Pancreatitis: A Randomized Trial.
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