Although they help relieve pain, nonsteroidal anti-inflammatory drugs (NSAIDs) have no established connection to mitigating complications among patients in the early stages of acute pancreatitis, said authors of a poster presentation at Digestive Disease Week 2023.

Acute pancreatitis is the most common pancreatic disease, leading to organ failure in 10% to 20% of patients, among whom the mortality rate is approximately 10%. NSAIDs have been the first line of therapy to alleviate pain among patients with acute pancreatitis, generally upon admission to the hospital. In addition, these drugs have also been used to prevent post-endoscopic cholangiopancreatography acute pancreatitis, the authors said. However, some patients believe that NSAIDs also help in reducing complications if administered early on in the course of the disease.

Between January 2015 and December 2018, the authors identified 1399 patients with a confirmed diagnosis of acute pancreatitis, according to International Classification of Diseases codes in 4 National Taiwan University-affiliated hospitals. They stratified the patients into NSAID users (patients who received NSAIDs between the index date and 3 days after the index date) and nonusers.

The primary outcome was early organ failure, and the secondary outcome was persistent organ failure.

Of the 1399 patients, the team reported that 70 patients (5.0%) were NSAID users. Compared to the nonusers, these patients were younger, had a lower APACHE II score, and a lower CCI score on the index date, the authors observed. Among all, 8 patients (0.6%) died of acute pancreatitis within 7 days of the index date, and 20 patients (1.4%) died within 30 days after the index date.

Based on propensity score-matched and augmented inverse probability-weighted analyses, the authors observed that there were “no significant differences between NSAIDs users and nonusers with respect to primary and secondary outcomes.” The real-world and hospital-based analysis found that there is no evidence that NSAIDs could reduce complications even if administered in the early stages of acute pancreatitis.

—Priyam Vora

Reference:
Wu H, Liao W, Chien K and Chen C. The NSAIDs use and early outcomes of acute pancreatitis: Real-world evidence. ePoster. Presentation #EP77. Presented at: Digestive Disease Week. Chicago, Illinois.