Do Prophylactic Prednisone and Allopurinol Prevent Post-ERCP Pancreatitis?

Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). To determine whether prophylactic prednisone and allopurinol reduce the incidence and severity of post-ERCP pancreatitis, researchers in Poland randomized 300 patients to receive prednisone (40 mg), allopurinol (200 mg), or placebo 15 hours and 3 hours prior to ERCP. The groups had similar demographic and procedure-related characteristics. Diagnosis of pancreatitis and grading of severity were based on consensus criteria.

Overall incidence of pancreatitis was 10.7 percent: Incidence was 12.0 percent in the prednisone group, 12.1 percent in the allopurinol group, and 7.9 percent in the placebo group (P=0.33 and 0.32 vs. placebo, respectively…