EVALUATION OF COX-2 INHIBITORS IN PREVENTION OF SEVERE FORM OF ACUTE PANCREATITIS

Abstract

Introduction: Gallstones and alcohol misuse activate damaging enzyme cascades, causing acute pancreatitis. Categorization systems use criteria such as SIRS, organ failure, and necrotizing pancreatitis to determine the severity. COX-2 inhibitors may suppress inflammation and prevent severe manifestations. Antibiotics, ERCP, procedures, and supportive care are used. For better survival, severe acute pancreatitis requires novel gut barrier failure and inflammatory response prevention.

Aim and objectives: This study evaluates the efficacy of COX-2 inhibitors in avoiding severe acute pancreatitis and assessing their influence on illness severity and outcomes.

Method: In a prospective single-center randomized controlled trial conducted at the Department of General Surgery during the period of one year, patients with acute pancreatitis (AP) were randomly assigned to either a COX-2 inhibitor group or a control group. Patients in the COX-2 group received parecoxib and celecoxib, while the control group received placebos. Assessment criteria included APACHE-II, SIRS, and OF (1) scores, self-assessed abdominal pain ratings, and inflammatory markers. Inclusion criteria involved age, confirmed AP diagnosis, APACHE II score, and written consent, while exclusion criteria included pregnancy, severe chronic diseases, drug allergies, and psychosis. Follow-up study was done and organ failures, occurrence of severe acute pancreatitis and secondary outcomes were assessed and analyzed statistically between the groups anc conclusion was drawn.

Result: There was a good match in terms of baseline characteristics between the control and Cox-2 groups in this trial of 110 people. The death rates were similar in both groups, while the Cox-2 group had a greater incidence of SAP. Reducing organ failure and improving secondary outcomes may be associated with Cox-2 treatment. To learn how Cox-2 inhibitors affect acute pancreatitis disease severity and patient outcomes, more research is necessary.

Conclusion: Using COX-2 inhibitors sequentially in SAP patients reduced the incidence of SAP, decreased TNF-a and IL-6, and increased the cost-effectiveness of symptom treatment.

Keywords: “COX-2 inhibitors (C1COX-2-Is)”, SAP, harms cells, disrupting enzyme.