{
  "abstract": "Background There is no effective drug treatment for the organ failure (OF) caused by severe acute pancreatitis (SAP).Objective We aimed to evaluate the efficacy of cyclooxygenase-2 inhibitors (COX-2-Is) on the treatment of SAP and its safety.Design In this multicentre, double-blind, randomised, placebo-controlled, investigator-initiated trial, 348 patients with acute pancreatitis aged 18–75 years, <1 week from onset of illness to admission, and Acute Physiology and Chronic Health Evaluation II Score ≥7 or modified Marshall Score ≥2, were randomly assigned (1:1) to the COX-2-Is group (parecoxib sequential with imrecoxib) or the placebo group. SAP occurrence, duration of OF, local complications, clinical outcomes and serum inflammatory mediators were measured.Results Compared with the placebo group, SAP occurrence was reduced by 20.7% (77.6% vs 61.5%, p=0.001) and the persistent OF duration in SAP was shortened by 2 days (p<0.001) after COX-2-Is treatment. For patients enrolled within or after 48 hours from symptom onset, SAP occurrence was reduced by 23.8% (p=0.001) and 8.5% (p=0.202), and the persistent OF duration in SAP was shortened by 3 days (p=0.001) and 2 days (p=0.010) after COX-2-Is treatment, respectively. The occurrence of local complications in the COX-2-Is group was significantly lower than those in the placebo group, 33.7% vs 49.1%, p=0.004. The serum levels of inflammatory mediators and 30-day mortality (from 8.6% to 3.4%) were significantly reduced after COX-2-Is treatment, p<0.05. The incidence of adverse events was similar between the two treatment groups.Conclusion Parecoxib sequential with imrecoxib was effective and well tolerated in reducing the occurrence and duration of SAP and local complications through suppression of systemic inflammatory response, leading to decreased morbidity.",
  "authors": [
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China",
        "Lab of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Luming Huang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Zhe Feng"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Wenjuan Yang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"
      ],
      "name": "Yin Zhu"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Jing Li"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Libin Huang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Rui Wang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Wenjiang District People’s Hospital, Chengdu, Sichuan, China"
      ],
      "name": "Lan Peng"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Nanbu Country People’s Hospital, Nanchong, Sichuan, China"
      ],
      "name": "Mingshun He"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China"
      ],
      "name": "Yingmei Tang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China"
      ],
      "name": "Ping Chen"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hainan Medical University Affiliated Hainan Hospital, Haikou, Hainan, China"
      ],
      "name": "Cheng Lan"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Nanchong Central Hospital, Nanchong, Sichuan, China"
      ],
      "name": "Xiaoqing Zhou"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China"
      ],
      "name": "Lin Zhou"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, Zhejiang, China"
      ],
      "name": "Cheng Ye"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Linhao Zhang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Jingsun Jiang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Yanting Ye"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Rui Wang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Yan He"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Yan Liu"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Hui Gong"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"
      ],
      "name": "Huifang Xiong"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"
      ],
      "name": "Liang Xia"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Wenjiang District People’s Hospital, Chengdu, Sichuan, China"
      ],
      "name": "Haiyan Xu"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Nanbu Country People’s Hospital, Nanchong, Sichuan, China"
      ],
      "name": "Bin Zhang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China"
      ],
      "name": "Rongfang Tu"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China"
      ],
      "name": "Chun Du"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Hainan Medical University Affiliated Hainan Hospital, Haikou, Hainan, China"
      ],
      "name": "Lujia Cui"
    },
    {
      "affiliations": [
        "Lab of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Jinhang Gao"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China",
        "Lab of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Zhiyin Huang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China",
        "Lab of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu, Sichuan, China"
      ],
      "name": "Chengwei Tang"
    }
  ],
  "title": "Parecoxib sequential with imrecoxib for occurrence and remission of severe acute pancreatitis: a multicentre, double-blind, randomised, placebo-controlled trial",
  "uid": "401d4735-0d7c-5de7-9898-a56b93572625"
}