Nafamostat Mesilate for Prevention of Post-ERCP Pancreatitis. Issue 4 (May 2015)

• Record Type: Journal Article
• Authors: Yu, Ge; Li, Shuang; Wan, Rong; Wang, Xingpeng; Hu, Guoyong
• Is Part Of: Pancreas. Volume 44:Issue 4(2015)
• Publication Date: 2015-05
• Subjects: Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000000310
• Languages: English
• ISSNs: 0885-3177

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objectives</title> <p>We aimed to evaluate the efficacy of nafamostat on the prevention of post–endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).</p> </sec> <sec> <title>Methods</title> <p>Medline, Embase, Cochrane Central Register of Controlled Trials, and Web of Science were searched until April 18, 2014.</p> </sec> <sec> <title>Results</title> <p>Seven randomized controlled trials and 2956 patients met the search criteria. When compared with nonnafamostat, the incidence of PEP was reduced to 53% in the patients who received nafamostat (risk ratio [RR], 0.47; 95% confidence interval [CI], 0.34–0.63). Further analyses were conducted based on the different risk classifications (n = 641 in patients with high risks: RR, 0.54; 95% CI, 0.30–0.96 and n = 944 with low risks: RR, 0.31; 95% CI, 0.17–0.56), PEP severities (n = 1654: RR, 0.38; 95% CI, 0.25–0.59 for mild; RR, 0.37; 95% CI, 0.15–0.96 for moderate; RR, 0.92; 95% CI, 0.13–6.38 for severe), and nafamostat doses (n = 1902: RR, 0.42; 95% CI, 0.28–0.63 for 20 mg; n = 1150: RR, 0.40; 95% CI, 0.25–0.63 for 50 mg). However, there was no reduction of the incidence of post-ERCP hyperamylasemia (n = 1585; 95% CI, 0.68–1.45) or cannulation difficulty (n = 1585; 95% CI, 0.91–1.23).</p> </sec> <sec> <title>Conclusions</title> <p>Pooled analyses from current randomized controlled trials support the effectiveness of nafamostat for prophylaxis of PEP.</p> </sec> </abstract>