Parecoxib Improves the Outcomes of Acute Mild and Moderate Pancreatitis: A 3-Year Matched Cohort Study Based on a Prospective Database

Pancreas. 2019 Oct;48(9):1148-1154. doi: 10.1097/MPA.0000000000001393.

Abstract

Objectives: The aim of this study was to evaluate the role of parecoxib in patients with different severities of acute pancreatitis (AP).

Methods: A total of 772 eligible patients with AP were divided into 4 groups: mild and moderately AP (MAP) treated with parecoxib (group A, n = 236), MAP without parecoxib treatment (group B, n = 453), severe AP (SAP) treated with parecoxib (group C, n = 28), and SAP without parecoxib treatment (group D, n = 55). Patients in group A were exactly matched with patients in group B by propensity score matching, similar to the matching between group C and group D.

Results: The morbidity of abdominal infection in group A was significantly lower as compared with that in group B (P < 0.050). The progression of MAP to SAP significantly decreased in group A than group B (P < 0.050). No significant differences were observed between group C and group D. The risk factors independently related to the progression of MAP included alcoholic/high-fat dietary (P = 0.028) and parecoxib administration (P = 0.011).

Conclusions: Early administration of parecoxib could reduce the morbidity of complications among patients with MAP. Parecoxib may prevent the progression of MAP to SAP and improve its outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Bacterial Infections / etiology
  • Bacterial Infections / prevention & control
  • Cohort Studies
  • Cyclooxygenase 2 Inhibitors / therapeutic use
  • Databases, Factual / statistics & numerical data*
  • Disease Progression
  • Female
  • Fever / etiology
  • Fever / prevention & control
  • Humans
  • Isoxazoles / therapeutic use*
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Pancreatitis / complications
  • Pancreatitis / drug therapy*
  • Pancreatitis / pathology
  • Protective Agents / therapeutic use
  • Severity of Illness Index*

Substances

  • Cyclooxygenase 2 Inhibitors
  • Isoxazoles
  • Protective Agents
  • parecoxib