Evidence map›Paper›PMID 37981523›Full record

SynthesisPancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]2024

NSAIDs do not reduce severity among post-ERCP pancreatitis patients.

Bara El Kurdi, Zaid Imam, Abdulrahman Abonofal, Sumbal Babar, Pir Shah, Rahul Pannala, Georgios Papachristou, Juan Echavarria, Sailaja Pisipati, Sarah Jahangir and 3 more

Open access · greenAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Why is the rectal route for NSAIDS favorable for preventing post-ERCP pancreatitis?Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2025
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Bara El KurdiDepartment of Internal Medicine East Tennessee State University, Johnson City, TN, USA; Division of Gastroenterology and Hepatology, University of Texas Health at San Antonio, TX, USA. Electronic address: Belkurdi@carilionclinic.org.
Zaid ImamDivision of Gastroenterology and Hepatology, William Beaumont Hospital, Royal Oak, MI, USA.
Abdulrahman AbonofalDepartment of Internal Medicine East Tennessee State University, Johnson City, TN, USA.
Sumbal BabarDepartment of Internal Medicine East Tennessee State University, Johnson City, TN, USA.
Pir ShahDivision of Gastroenterology and Hepatology, University of Texas Health at San Antonio, TX, USA.
Rahul PannalaDivision of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
Georgios PapachristouDivision of Gastroenterology and Hepatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Juan EchavarriaDivision of Gastroenterology and Hepatology, University of Texas Health at San Antonio, TX, USA.
Sailaja PisipatiDivision of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
Sarah JahangirDivision of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
Prasad RajalingamgariDivision of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
Yu-Hui H ChangDepartment of Biostatistics, Mayo Clinic Arizona, Scottsdale, AZ, USA.
Vijay P SinghDivision of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, AZ, USA. Electronic address: singh.vijay@mayo.edu.
Mayo Clinic in Arizona · USEast Tennessee State University · USThe University of Texas Health Science Center at San Antonio · USBeaumont Hospital, Royal Oak · USThe Ohio State University Wexner Medical Center · US

Funding

Obesity related pancreatic fat worsens local injury via unsaturated fatty acidsR01DK092460 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SINGH, VIJAY PREM · 2011 to 2024
$5.5M
Pathogenesis of infection in pancreatitis: from sterile inflammation to sepsisR01DK119646 · NIDDK · MAYO CLINIC ARIZONA · PI SINGH, VIJAY PREM · 2019 to 2022
$1.9M
NIDDK NIH HHS R01 DK092460NIDDK NIH HHS R01 DK119646
6 · The paper itself

Abstract

objectiveNon-steroidal anti-inflammatory drugs (NSAIDs) are the most studied chemoprophylaxis for post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). While previous systematic reviews have shown NSAIDs reduce PEP, their impact on moderate to severe PEP (MSPEP) is unclear. We conducted a systematic review and meta-analysis to understand the impact of NSAIDs on MSPEP among patients who developed PEP. We later surveyed physicians' understanding of that impact.

designA systematic search for randomized trials using NSAIDs for PEP prevention was conducted. Pooled-prevalence and Odds-ratio of PEP, MSPEP were compared between treated vs. control groups. Analysis was performed using R software. Random-effects model was used for all variables. Physicians were surveyed via email before and after reviewing our results.

results7688 patients in 25 trials were included. PEP was significantly reduced to 0.598 (95%CI, 0.47-0.76) in the NSAIDs group. Overall burden of MSPEP was reduced among all patients undergoing ERCP: OR 0.59 (95%CI, 0.42-0.83). However, NSAIDs didn't affect the proportion of MSPEP among those who developed PEP (p = 0.658). Rectal Indomethacin and diclofenac reduced PEP but not MSPEP. Efficacy didn't vary by risk, timing of administration, or bias-risk. Survey revealed a change in the impression of the effect of NSAIDs on MSPEP after reviewing our results.

conclusionsRectal diclofenac or indomethacin before or after ERCP reduce the overall burden of MSPEP by reducing the pool of PEP from which it can arise. However, the proportion of MSPEP among patients who developed PEP is unaffected. Therefore, NSAIDs prevent initiation of PEP, but do not affect severity among those that develop PEP. Alternative modalities are needed to reduce MSPEP among patients who develop PEP.

Indexed as

DiclofenacPancreatitisAdministration, RectalAnti-Inflammatory Agents, Non-SteroidalCholangiopancreatography, Endoscopic RetrogradeHumansIndomethacinAnti-Inflammatory Agents, Non-SteroidalDiclofenacIndomethacin

Identifiers

PMID37981523
PMCPMC11298787
OpenAlexW4388248615

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.