Rectal NSAIDs-based combination modalities are superior to single modalities for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis: a network meta-analysis
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Background/Aims: Different modalities have been employed to reduce the risk and severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). However, there has been a paucity of studies comparing the efficacy of various prophylactic modalities for preventing PEP. This network meta-analysis (NMA) aimed to determine the relative efficacy of pancreatic duct stents and pharmacological modalities for preventing PEP. Methods: We performed a systematic and comprehensive search to identify and analyze all randomized controlled studies published until June 2020 that examined the effectiveness of pancreatic duct stents, rectal non-steroidal anti-inflammatory drugs (NSAIDs) based regimens, hydration, and their combinations for the prevention of PEP. The primary outcome was the frequency of PEP. An NMA was performed to combine direct and indirect comparisons of different prophylactic modalities. Results: The NMA included 46 studies evaluating 18 regimens in 16,241 patients. Based on integral analysis of predictive interval plots, and expected mean ranking and surface under the cumulative ranking curve values, combination prophylaxis with indomethacin + lactated Ringer’s solution (LR), followed by diclofenac + nitrate and indomethacin + normal saline, was found to be the most efficacious modality for the overall prevention of PEP. Indomethacin + LR, followed by diclofenac and pancreatic duct stents, was the most efficacious modality for high-risk groups. Conclusions: Rectal NSAIDs-based combination regimens with aggressive hydration or nitrate are superior to single modalities for the prevention of PEP.
Abstract
Background/Aims: Different modalities have been employed to reduce the risk and severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). However, there has been a paucity of studies comparing the efficacy of various prophylactic modalities for preventing PEP. This network meta-analysis (NMA) aimed to determine the relative efficacy of pancreatic duct stents and pharmacological modalities for preventing PEP. Methods: We performed a systematic and comprehensive search to identify and analyze all randomized controlled studies published until June 2020 that examined the effectiveness of pancreatic duct stents, rectal non-steroidal anti-inflammatory drugs (NSAIDs) based regimens, hydration, and their combinations for the prevention of PEP. The primary outcome was the frequency of PEP. An NMA was performed to combine direct and indirect comparisons of different prophylactic modalities. Results: The NMA included 46 studies evaluating 18 regimens in 16,241 patients. Based on integral analysis of predictive interval plots, and expected mean ranking and surface under the cumulative ranking curve values, combination prophylaxis with indomethacin + lactated Ringer’s solution (LR), followed by diclofenac + nitrate and indomethacin + normal saline, was found to be the most efficacious modality for the overall prevention of PEP. Indomethacin + LR, followed by diclofenac and pancreatic duct stents, was the most efficacious modality for high-risk groups. Conclusions: Rectal NSAIDs-based combination regimens with aggressive hydration or nitrate are superior to single modalities for the prevention of PEP.
참고문헌 (77)
- Cotton PB, "Endoscopic sphincterotomy complications and their management : an attempt at consensus", Gastrointest Endosc, 37, pp.383~393 (1991)
- Thiruvengadam NR, "Rectal indomethacin reduces pancreatitis in high-and low-risk patients undergoing endoscopic retrograde cholangiopancreatography", Gastroenterology, 151, pp.288~297 (2016)
- Luo H, "Routine pre-procedural rectal indometacin versus selective post-procedural rectal indometacin to prevent pancreatitis in patients undergoing endoscopic retrograde cholangiopancreatography : a multicentre, single-blinded, randomised controlled trial", Lancet, 387, pp.2293~2301 (2016)
- Elmunzer BJ, "A randomized trial of rectal indomethacin to prevent post-ERCP pancreatitis", N Engl J Med, 366, pp.1414~1422 (2012)
- Freeman ML, "Prevention of post-ERCP pancreatitis : a comprehensive review", Gastrointest Endosc, 59, pp.845~864 (2004)
- Tae Young Park, "Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis with rectal non-steroidal anti-inflammatory drugs", The Korean Journal of Internal Medicine, 35(3), pp.535~543 (2020), 대한내과학회[DOI]
- Akshintala VS, "Systematic review with network meta-analysis : pharmacological prophylaxis against post-ERCP pancreatitis", Aliment Pharmacol Ther, 38, pp.1325~1337 (2013)
- Kubiliun NM, "Evaluation of pharmacologic prevention of pancreatitis after endoscopic retrograde cholangiopancreatography : a systematic review", Clin Gastroenterol Hepatol, 13, pp.1231~1239 (2015)
- Patai A, "Effect of rectal indomethacin for preventing post-ERCP pancreatitis depends on difficulties of cannulation : results from a randomized study with sequential biliary intubation", J Clin Gastroenterol, 49, pp.429~437 (2015)
- Patai A, "Indomethacin and diclofenac in the prevention of post-ERCP pancreatitis : a systematic review and meta-analysis of prospective controlled trials", Gastrointest Endosc, 85, pp.1144~1156 (2017)
- Levenick JM, "Rectal indomethacin does not prevent post-ERCP pancreatitis in consecutive patients", Gastroenterology, 150, pp.911~917 (2016)
- Sotoudehmanesh R, "Pharmacological prophylaxis versus pancreatic duct stenting plus pharmacological prophylaxis for prevention of post-ERCP pancreatitis in high risk patients : a randomized trial", Endoscopy, 51, pp.915~921 (2019)
- Smithline A, "Effect of prophylactic main pancreatic duct stenting on the incidence of biliary endoscopic sphincterotomy-induced pancreatitis in high-risk patients", Gastrointest Endosc, 39, pp.652~657 (1993)
- Lee TH, "Prophylactic temporary 3F pancreatic duct stent to prevent post-ERCP pancreatitis in patients with a difficult biliary cannulation : a multicenter, prospective, randomized study", Gastrointest Endosc, 76, pp.578~585 (2012)
- Sofuni A, "Endoscopic pancreatic duct stents reduce the incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients", Clin Gastroenterol Hepatol, 9, pp.851~858 (2011)
- Conigliaro R, "Pancreatic duct stenting for the duration of ERCP only does not prevent pancreatitis after accidental pancreatic duct cannulation : a prospective randomized trial", Surg Endosc, 27, pp.569~574 (2013)
- Choudhary A, "Pancreatic stents for prophylaxis against post-ERCP pancreatitis : a meta-analysis and systematic review", Gastrointest Endosc, 73, pp.275~282 (2011)
- Wu BU, "Lactated Ringer’s solution reduces systemic inflammation compared with saline in patients with acute pancreatitis", Clin Gastroenterol Hepatol, 9, pp.710~717 (2011)
- Buxbaum JL, "Early aggressive hydration hastens clinical improvement in mild acute pancreatitis", Am J Gastroenterol, 112, pp.797~803 (2017)
- Tenner S, "American College of Gastroenterology guideline : management of acute pancreatitis", Am J Gastroenterol, 108, pp.1400~1416 (2013)
- Buxbaum J, "Aggressive hydration with lactated Ringer’s solution reduces pancreatitis after endoscopic retrograde cholangiopancreatography", Clin Gastroenterol Hepatol, 12, pp.303~307 (2014)
- Choi JH, "Vigorous periprocedural hydration with lactated Ringer’s solution reduces the risk of pancreatitis after retrograde cholangiopancreatography in hospitalized patients", Clin Gastroenterol Hepatol, 15, pp.86~92 (2017)
- Park CH, "Aggressive intravenous hydration with lactated Ringer’s solution for prevention of post-ERCP pancreatitis : a prospective randomized multicenter clinical trial", Endoscopy, 50, pp.378~385 (2018)
- Wu D, "The efficiency of aggressive hydration with lactated Ringer solution for the prevention of post-ERCP pancreatitis : a systematic review and meta-analysis", J Clin Gastroenterol, 51, pp.e68~e76 (2017)
- Tomoda T, "Combination of diclofenac and sublingual nitrates is superior to diclofenac alone in preventing pancreatitis after endoscopic retrograde cholangiopancreatography", Gastroenterology, 156, pp.1753~1760 (2019)
- Sotoudehmanesh R, "A randomized trial of rectal indomethacin and sublingual nitrates to prevent post-ERCP pancreatit is", Am J Gastroenterol, 109, pp.903~909 (2014)
- Lumley T, "Network meta-analysis for indirect treatment comparisons", Stat Med, 21, pp.2313~2324 (2002)
- Shamseer L, "Preferred reporting items for systematic review and meta-analysis protocols(PRISMA-P)2015 : elaboration and explanation", BMJ, 350, pp.g7647~ (2015)
- Higgins JPT, "Cochrane Handbook for Systematic Reviews of Intervention" (2019), The Cochrane Collaboration
- Cornell JE, "The PRISMA extension for network meta-analysis : bringing clarity and guidance to the reporting of systematic reviews incorporating network meta-analyses", Ann Intern Med, 162, pp.797~798 (2015)
- Higgins J, "Cochrane Handbook for Systematic Reviews of Interventions version", pp.205~228 (2019), The Cochrane Collaboration
- Chaimani A, "Graphical tools for network meta-analysis in STATA", PLoS One, 8, pp.e76654~ (2013)
- White IR, "Consistency and inconsistency in network meta-analysis : model estimation using multivariate meta-regression", Res Synth Methods, 3, pp.111~125 (2012)
- Salanti G, "Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis : an overview and tutorial", J Clin Epidemiol, 64, pp.163~171 (2011)
- Riley RD, "Interpretation of random effects meta-analyses", BMJ, 342, pp.d549~ (2011)
- Atkins D, "Grading quality of evidence and strength of recommendations", BMJ, 328, pp.1490~ (2004)
- Tarnasky PR, "Pancreatic stenting prevents pancreatitis after biliary sphincterotomy in patients with sphincter of Oddi dysfunction", Gastroenterology, 115, pp.1518~1524 (1998)
- Fazel A, "Does a pancreatic duct stent prevent post-ERCP pancreatitis? A prospective randomized study", Gastrointest Endosc, 57, pp.291~294 (2003)
- Tsuchiya T, "Temporary pancreatic stent to prevent post endoscopic retrograde cholangiopancreatography pancreatitis : a preliminary, single-center, randomized controlled trial", J Hepatobiliary Pancreat Surg, 14, pp.302~307 (2007)
- Ito K, "Can pancreatic duct stenting prevent post-ERCP pancreatitis in patients who undergo pancreatic duct guidewire placement for achieving selective biliary cannulation? A prospective randomized controlled trial", J Gastroenterol, 45, pp.1183~1191 (2010)
- Sofuni A, "Prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis by an endoscopic pancreatic spontaneous dislodgement stent", Clin Gastroenterol Hepatol, 5, pp.1339~1346 (2007)
- Pan XP, "Clinical study on the prevention of post-ERCP pancreatitis by pancreatic duct stenting", Cell Biochem Biophys, 61, pp.473~479 (2011)
- Kawaguchi Y, "Randomized controlled trial of pancreatic stenting to prevent pancreatitis after endoscopic retrograde cholangiopancreatography", World J Gastroenterol, 18, pp.1635~1641 (2012)
- Yin HK, "Pancreatic stenting reduces post-ERCP pancreatitis and biliary sepsis in high-risk patients : a randomized, controlled study", Gastroenterol Res Pract, 2016, pp.9687052~ (2016)
- Phillip V, "Pancreatic stenting to prevent post-ERCP pancreatitis : a randomized multicenter trial", Endosc Int Open, 7, pp.E860~E868 (2019)
- Murray B, "Diclofenac reduces the incidence of acute pancreatitis after endoscopic retrograde cholangiopancreatography", Gastroenterology, 124, pp.1786~1791 (2003)
- Sotoudehmanesh R, "Indomethacin may reduce the incidence and severity of acute pancreatitis after ERCP", Am J Gastroenterol, 102, pp.978~983 (2007)
- Montano Loza A, "Effect of the administration of rectal indomethacin on amylase serum levels after endoscopic retrograde cholangiopancreatography, and its impact on the development of secondary pancreatitis episodes", Rev Esp Enferm Dig, 99, pp.330~336 (2007)
- Khoshbaten M, "Role of diclofenac in reducing post-endoscopic retrograde cholangiopancreatography pancreatitis", J Gastroenterol Hepatol, 23(7 Pt 2), pp.e11~e16 (2008)
- Otsuka T, "Low-dose rectal diclofenac for prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis : a randomized controlled trial", J Gastroenterol, 47, pp.912~917 (2012)
- Dobronte Z, "Is rectal indomethacin effective in preventing of post-endoscopic retrograde cholangiopancreatography pancreatitis?", World J Gastroenterol, 20, pp.10151~10157 (2014)
- Andrade-Davila VF, "Rectal indomethacin versus placebo to reduce the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography : results of a controlled clinical trial", BMC Gastroenterol, 15, pp.85~ (2015)
- Lua GW, "Can rectal diclofenac prevent post endoscopic retrograde cholangiopancreatography pancreatitis?", Dig Dis Sci, 60, pp.3118~3123 (2015)
- Mansour-Ghanaei F, "Suppository naproxen reduces incidence and severity of post-endoscopic retrograde cholangiopancreatography pancreatitis : randomized controlled trial", World J Gastroenterol, 22, pp.5114~5121 (2016)
- Shafique MS, "Prophylactic rectal NSAIDS in the prevention of POST-ERCP pancreatitis", J Postgrad Med Inst, 30, pp.184~188 (2016)
- Katoh T, "Low-dose rectal diclofenac does not prevent post-ERCP pancreatitis in low-or high-risk patients", J Gastroenterol Hepatol, 35, pp.1247~1253 (2020)
- Hosseini M, "Prophylactic effect of rectal indomethacin administration, with and without intravenous hydration, on development of endoscopic retrograde cholangiopancreatography pancreatitis episodes : a randomized clinical trial", Arch Iran Med, 19, pp.538~543 (2016)
- Mok S, "Lactated Ringer’s solution in combination with rectal indomethacin for prevention of post-ERCP pancreatitis and readmission : a prospective randomized, double-blinded, placebo-controlled trial", Gastrointest Endosc, 85, pp.1005~1013 (2017)
- Hajalikhani M, "Combination of diclofenac and aggressive hydration for the prevention of post-ERCP pancreatitis", Gastroenterol Hepatol Bed Bench, 11, pp.319~324 (2018)
- Katsinelos P, "Combination of diclofenac plus somatostatin in the prevention of post-ERCP pancreatitis : a randomized, double-blind, placebo-controlled trial", Endoscopy, 44, pp.53~59 (2012)
- Hatami B, "Epinephrine in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis : a preliminary study", Case Rep Gastroenterol, 12, pp.125~136 (2018)
- Kamal A, "A randomized trial of topical epinephrine and rectal indomethacin for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients", Am J Gastroenterol, 114, pp.339~347 (2019)
- Luo H, "Rectal indomethacin and spraying of duodenal papilla with epinephrine increases risk of pancreatitis following endoscopic retrograde cholangiopancreatography", Clin Gastroenterol Hepatol, 17, pp.1597~1606 (2019)
- Lai JH, "A randomized trial comparing the efficacy of single-dose and double-dose administration of rectal indomethacin in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis", Medicine(Baltimore), 98, pp.e15742~ (2019)
- Fogel EL, "Rectal indometacin dose escalation for prevention of pancreatitis after endoscopic retrograde cholangiopancreatography in high-risk patients : a double-blind, randomised controlled trial", Lancet Gastroenterol Hepatol, 5, pp.132~141 (2020)
- Shaygan-Nejad A, "Aggressive hydration with lactated Ringer’s solution as the prophylactic intervention for postendoscopic retrograde cholangiopancreatography pancreatitis : a randomized controlled double-blind clinical trial", J Res Med Sci, 20, pp.838~843 (2015)
- Masjedizadeh A, "Comparative effectiveness of aggressive intravenous fluid resuscitation with lactated Ringer’s solution and rectal indomethacin therapy in the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography : a double blind randomised controlled clinical trial", Prz Gastroenterol, 12, pp.271~276 (2017)
- Ghaderi R, "Effect of aggressive fluid therapy on outcomes after endoscopic retrograde cholangiopancreatography : a randomized controlled clinical trial", Middle East J Dig Dis, 11, pp.76~83 (2019)
- Dumonceau JM, "ERCP-related adverse events : European Society of Gastrointestinal Endoscopy(ESGE)Guideline", Endoscopy, 52, pp.127~149 (2020)
- Njei B, "Comparative effectiveness of pharmacologic and endoscopic interventions for prevention of post-ERCP pancreatitis : a network meta-analysis", Endosc Int Open, 8, pp.E29~E40 (2020)
- Shou-Xin Y, "Rectal nonsteroidal anti-inflammatory drugs and pancreatic stents in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis in high-risk patients: a network meta-analysis", Medicine(Baltimore), 99, pp.e22672~ (2020)
- Yang J, "Rectal nonsteroidal anti-inflammatory drugs for endoscopic retrograde cholangiopancreatography postoperative pancreatitis prevention : a network meta-analysis", J Clin Gastroenterol, 54, pp.305~313 (2020)
- Dubravcsik Z, "Network meta-analysis of prophylactic pancreatic stents and non-steroidal anti-inflammatory drugs in the prevention of moderate-to-severe post-ERCP pancreatitis", Pancreatology, 21, pp.704~713 (2021)
- Akbar A, "Rectal nonsteroidal anti-inflammatory drugs are superior to pancreatic duct stents in preventing pancreatitis after endoscopic retrograde cholangiopancreatography : a network meta-analysis", Clin Gastroenterol Hepatol, 11, pp.778~783 (2013)
- Elmunzer BJ, "Rectal indomethacin alone versus indomethacin and prophylactic pancreatic stent placement for preventing pancreatitis after ERCP : study protocol for a randomized controlled trial", Trials, 17, pp.120~ (2016)
- Choksi NS, "The risk of post-ERCP pancreatitis and the protective effect of rectal indomethacin in cases of attempted but unsuccessful prophylactic pancreatic stent placement", Gastrointest Endosc, 81, pp.150~155 (2015)
- Oh HC, "Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis with a combination of pharmacological agents based on rectal non-steroidal anti-inflammatory drugs : a systematic review and network meta-analysis", J Gastroenterol Hepatol, 36, pp.1403~1413 (2021)
