Preventive effect of tacrolimus on patients with post-endoscopic retrograde cholangiopancreatography pancreatitis
BACKGROUND/AIMS: In patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), calcineurin activates zymogen, which results in pancreatitis. In this study, we aimed to determine the efficacy of tacrolimus, a calcineurin inhibitor, in preventing post-ERCP pancreatitis (PEP).
METHODS: This was a prospective pilot study in which patients who underwent ERCP received tacrolimus (4 mg in two divided doses); this was the Tac group. A contemporaneous cohort of patients was included as a control group. All patients were followed-up for PEP. PEP was characterized by worsening abdominal pain with an acute onset, elevated pancreatic enzymes, and a duration of hospital stay of more than 48 hours. Serum tacrolimus levels were measured immediately before the procedure in the Tac group.
RESULTS: There were no differences in the baseline characteristics between the Tac group (n=48) and the control group (n=51). Only four out of 48 patients (8.3%) had PEP in the Tac group compared to eight out of 51 patients (15.7%) who had PEP in the control group. The mean trough tacrolimus level in patients who developed PEP was significantly lower (p<0.05).
CONCLUSION: Oral tacrolimus at a cumulative dose of 4 mg safely prevents PEP. Further randomized controlled studies are warranted to establish the role of tacrolimus in this context.
| Errataetall: |
CommentIn: Clin Endosc. 2022 Sep;55(5):628-629. - PMID 36031763 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:55 |
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| Enthalten in: |
Clinical endoscopy - 55(2022), 5 vom: 14. Sept., Seite 665-673 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rao B, Harshavardhan [VerfasserIn] |
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| Links: |
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| Themen: |
Calcineurin |
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| Anmerkungen: |
Date Revised 19.10.2022 published: Print-Electronic CommentIn: Clin Endosc. 2022 Sep;55(5):628-629. - PMID 36031763 Citation Status PubMed-not-MEDLINE |
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| doi: |
10.5946/ce.2021.265 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM344346773 |
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| 500 | |a Date Revised 19.10.2022 | ||
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| 500 | |a CommentIn: Clin Endosc. 2022 Sep;55(5):628-629. - PMID 36031763 | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a BACKGROUND/AIMS: In patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), calcineurin activates zymogen, which results in pancreatitis. In this study, we aimed to determine the efficacy of tacrolimus, a calcineurin inhibitor, in preventing post-ERCP pancreatitis (PEP) | ||
| 520 | |a METHODS: This was a prospective pilot study in which patients who underwent ERCP received tacrolimus (4 mg in two divided doses); this was the Tac group. A contemporaneous cohort of patients was included as a control group. All patients were followed-up for PEP. PEP was characterized by worsening abdominal pain with an acute onset, elevated pancreatic enzymes, and a duration of hospital stay of more than 48 hours. Serum tacrolimus levels were measured immediately before the procedure in the Tac group | ||
| 520 | |a RESULTS: There were no differences in the baseline characteristics between the Tac group (n=48) and the control group (n=51). Only four out of 48 patients (8.3%) had PEP in the Tac group compared to eight out of 51 patients (15.7%) who had PEP in the control group. The mean trough tacrolimus level in patients who developed PEP was significantly lower (p<0.05) | ||
| 520 | |a CONCLUSION: Oral tacrolimus at a cumulative dose of 4 mg safely prevents PEP. Further randomized controlled studies are warranted to establish the role of tacrolimus in this context | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Calcineurin | |
| 650 | 4 | |a Endoscopic retrograde cholangiopancreatography | |
| 650 | 4 | |a Pancreatitis | |
| 650 | 4 | |a Prophylaxis | |
| 650 | 4 | |a Tacrolimus | |
| 700 | 1 | |a Vincent, Paul K |e verfasserin |4 aut | |
| 700 | 1 | |a Nair, Priya |e verfasserin |4 aut | |
| 700 | 1 | |a Koshy, Anoop K |e verfasserin |4 aut | |
| 700 | 1 | |a Venu, Rama P |e verfasserin |4 aut | |
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