Faculty, Staff and Student Publications

Publication Date

1-1-2023

Journal

Pancreatology

DOI

10.1016/j.pan.2022.12.008

PMID

36535851

PMCID

PMC9839482

PubMedCentral® Posted Date

1-1-2024

PubMedCentral® Full Text Version

Author MSS

Abstract

Background/objectives: Current treatments for chronic pancreatitis focus on symptom management and therapeutics targeting disease reversal are lacking. Given the role of the cyclooxygenase-2 (COX-2) enzyme in producing prostaglandin E2 (PGE2), a key component in the inflammatory pathway of chronic pancreatitis, this study evaluates the physiologic effect of oral indomethacin, a COX-2 inhibitor, on PGE2 levels in pancreatic fluid.

Methods: This pilot two-center randomized controlled trial seeks to examine 32 subjects with chronic pancreatitis who have no contraindications to indomethacin. Subjects will be randomized to either oral indomethacin 50 mg twice a day or placebo twice a day for a total of 28 days. Baseline (pre-treatment) assessment of pain and quality of life will be performed using the Brief Pain Inventory and the PROMIS-10 questionnaires, respectively. Biological specimens including blood, urine, and saliva will be collected at pre-treatment and post-treatment(day 28). Endoscopic pancreatic function testing with concomitant pancreatic fluid collection will also be performed pre- and post-treatment to assess the change in pancreatic fluid PGE2 levels. The relationship between pancreatic fluid PGE2 levels with blood and saliva PGE2 levels will be examined.

Conclusions: This study will elucidate the effect of oral indomethacin on PGE2 levels in the pancreas to assess its role in the inflammatory pathway of chronic pancreatitis. Should indomethacin significantly reduce PGE2 levels, this may represent a potential disease-altering treatment for chronic pancreatitis.

Keywords

Humans, Indomethacin, Quality of Life, Pancreatitis, Chronic, Anti-Inflammatory Agents, Non-Steroidal, Pancreas, Randomized Controlled Trials as Topic, Multicenter Studies as Topic, Clinical Trials, Phase I as Topic, Clinical Trials, Phase II as Topic

Published Open-Access

yes

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