Advances in Glucocorticoid Therapy for Acute Pancreatitis: A Review.

Abstract

Background: Acute pancreatitis (AP) is a prevalent gastrointestinal emergency with a substantial risk of severe complications. Evidence indicates that glucocorticoids (GCs) may attenuate organ failure and reduce mortality in AP through their anti-inflammatory and immunomodulatory properties. However, the therapeutic application of GCs in AP remains contentious due to potential adverse effects, such as heightened infection risk and exacerbation of pancreatic injury.

Objective: This review evaluates recent developments in GC therapy for AP, with an emphasis on their mechanisms of action, therapeutic efficacy, and associated risks.

Methods: A review investigates the role of GCs in AP pathophysiology, their impact on inflammatory markers, organ function, survival outcomes, and the ongoing controversies regarding their clinical efficacy and safety.

Results: Current evidence suggests that GCs may attenuate inflammation and enhance survival in animal models and select clinical studies on AP. Yet, findings regarding their impact on disease progression and patient outcomes remain inconclusive. In addition, combination therapies incorporating GCs may be most effective within a multimodal therapeutic approach.

Conclusion: GCs exhibit potential in the management of AP by modulating inflammatory pathways and immune responses. Their use necessitates thorough risk assessment. Large-scale clinical trials are essential to establish standardized protocols, optimal dosing regimens, and patient selection criteria for GCs therapy in AP.