Efficacy of 2‐Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label Trial
ABSTRACT Background and Aim Oxidative stress has been considered a factor in the development of post‐endoscopic retrograde cholangiopancreatography pancreatitis (PEP). The present clinical trial evaluated whether adding intravenous mesna to rectal indomethacin could prevent or alleviate PEP. Methods...
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2025-01-01
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| Online Access: | https://doi.org/10.1002/jgh3.70083 |
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| author | Amir Sadeghi Hesamoddin Samar Mohammad Abbasinazari Parvaneh Mohammadi Ali Abazarikia Shadi Ziaie |
| author_facet | Amir Sadeghi Hesamoddin Samar Mohammad Abbasinazari Parvaneh Mohammadi Ali Abazarikia Shadi Ziaie |
| author_sort | Amir Sadeghi |
| collection | DOAJ |
| description | ABSTRACT Background and Aim Oxidative stress has been considered a factor in the development of post‐endoscopic retrograde cholangiopancreatography pancreatitis (PEP). The present clinical trial evaluated whether adding intravenous mesna to rectal indomethacin could prevent or alleviate PEP. Methods An open‐labeled clinical trial was done on 698 participants undergoing endoscopic retrograde cholangiopancreatography (ERCP). Eligible patients received 100 mg indomethacin suppository 30 min before undergoing ERCP. Randomly, the participants received 400 mg intravenous mesna or nothing 30 min before doing the procedure. The PEP incidence and degree were measured in the patients as the main outcome. Results The total rate of PEP was equal to 13.7%. No significant difference was seen in the rate and severity of PEP between the mesna plus indomethacin and indomethacin alone arms (14% vs. 13.4%, respectively, p = 0.671). In high‐risk patients, PEP rate and severity were lower in the mesna plus indomethacin group compared with indomethacin alone group and the statistical analysis showed that the difference was significant (41.7% vs. 51.8%, respectively, p = 0.033). Conclusion In high‐risk patients undergoing ERCP, a combination of intravenous mesna plus rectal indomethacin may decrease the PEP rate and severity. |
| format | Article |
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| institution | Kabale University |
| issn | 2397-9070 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| spelling | doaj-art-a1168a71722b46a9a963870d3f1bcb382025-01-28T09:24:33ZengWileyJGH Open2397-90702025-01-0191n/an/a10.1002/jgh3.70083Efficacy of 2‐Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label TrialAmir Sadeghi0Hesamoddin Samar1Mohammad Abbasinazari2Parvaneh Mohammadi3Ali Abazarikia4Shadi Ziaie5Gastroenterology and Liver Diseases Research Center Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences Tehran IranDepartment of Clinical Pharmacy School of Pharmacy, Shahid Beheshti University of Medical Sciences Tehran IranAnesthesiology Research Center Shahid Beheshti University of Medical Sciences Tehran IranGastroenterology and Liver Diseases Research Center Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences Tehran IranDepartment of Clinical Pharmacy School of Pharmacy, Shahid Beheshti University of Medical Sciences Tehran IranDepartment of Clinical Pharmacy School of Pharmacy, Shahid Beheshti University of Medical Sciences Tehran IranABSTRACT Background and Aim Oxidative stress has been considered a factor in the development of post‐endoscopic retrograde cholangiopancreatography pancreatitis (PEP). The present clinical trial evaluated whether adding intravenous mesna to rectal indomethacin could prevent or alleviate PEP. Methods An open‐labeled clinical trial was done on 698 participants undergoing endoscopic retrograde cholangiopancreatography (ERCP). Eligible patients received 100 mg indomethacin suppository 30 min before undergoing ERCP. Randomly, the participants received 400 mg intravenous mesna or nothing 30 min before doing the procedure. The PEP incidence and degree were measured in the patients as the main outcome. Results The total rate of PEP was equal to 13.7%. No significant difference was seen in the rate and severity of PEP between the mesna plus indomethacin and indomethacin alone arms (14% vs. 13.4%, respectively, p = 0.671). In high‐risk patients, PEP rate and severity were lower in the mesna plus indomethacin group compared with indomethacin alone group and the statistical analysis showed that the difference was significant (41.7% vs. 51.8%, respectively, p = 0.033). Conclusion In high‐risk patients undergoing ERCP, a combination of intravenous mesna plus rectal indomethacin may decrease the PEP rate and severity.https://doi.org/10.1002/jgh3.70083ERCPindomethacinMesnapancreatitistrial |
| spellingShingle | Amir Sadeghi Hesamoddin Samar Mohammad Abbasinazari Parvaneh Mohammadi Ali Abazarikia Shadi Ziaie Efficacy of 2‐Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label Trial JGH Open ERCP indomethacin Mesna pancreatitis trial |
| title | Efficacy of 2‐Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label Trial |
| title_full | Efficacy of 2‐Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label Trial |
| title_fullStr | Efficacy of 2‐Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label Trial |
| title_full_unstemmed | Efficacy of 2‐Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label Trial |
| title_short | Efficacy of 2‐Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label Trial |
| title_sort | efficacy of 2 mercaptoethane sulfonate sodium mesna in the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography a randomized open label trial |
| topic | ERCP indomethacin Mesna pancreatitis trial |
| url | https://doi.org/10.1002/jgh3.70083 |
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