Early Treatment With Dexamethasone in Mild Acute Pancreatitis
Intravenous Dexamethasone for the Early Treatment of Mild Acute Pancreatitis: A Double-Blind, Randomized, Placebo Controlled Trial
This pilot trial will evaluate the following in patients with acute pancreatitis:
- Safety profile of early treatment with intravenous dexamethasone
- Impact of dexamethasone on systemic inflammation in patients with acute pancreatitis
- Provide preliminary data on potential impact of early treatment with steroids on clinical outcomes
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Brigham and Women's Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age>=18 years
Diagnosis of acute pancreatitis confirmed by at least 2 of the following:
- Typical epigastric abdominal pain
- Elevation amylase/lipase >3 times upper limit normal and/or
- Confirmatory findings on cross-sectional imaging
- Enrollment within 8 hours of presentation
Exclusion Criteria:
- Class II or greater NYHA heart failure
- Oxygen dependent COPD
- Chronic kidney disease>stage 2
- Cirrhosis
- Existing necrosis on abdominal CT
- Organ dysfunction prior to enrollment
- Sepsis
- Acute respiratory distress syndrome
- Malignancy not in remission for at least 5 years
- Active drug use
- Known allergy to dexamethasone
- Altered mental status
- Insulin-requiring diabetes
- Abdominal surgery within 60 days
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: QUADRUPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: 10 mg intravenous dexamethasone
Subjects randomized to intervention arm will receive single dose of 10 mg intravenous dexamethasone.
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10 mg intravenous given as single administration with optional repeat dose after 36 hours.
|
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PLACEBO_COMPARATOR: Placebo
Equal volume of normal saline administered as a single intravenous dose at enrollment.
|
Normal saline
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Systemic Inflammation (measured by c-reactive protein level)
Time Frame: 48 hours
|
C-reactive protein (CRP) is a well-established inflammatory prognostic marker in acute pancreatitis.
Primary comparison will be between median CRP levels at 48 hours between treatment arms.
|
48 hours
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Safety parameters
Time Frame: 72 hours post-randomization
|
We will monitor for incidence of malignant hyperglycemia (blood sugar>400 mg/dL), psychosis or culture-documented infectious complications.
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72 hours post-randomization
|
|
Composite clinical outcome
Time Frame: Up to 14 days from hospital admission
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A composite clinical endpoint including development of either 1) pancreatic necrosis, 2) persistent organ dysfunction defined according to Atlanta symposium criteria 3) requirement for treatment in an intensive care unit and/or 4) development of culture-documented infection will be used to evaluate impact of treatment with dexamethasone on clinical outcomes in the study population.
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Up to 14 days from hospital admission
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Bechien U Wu, MD, MPH, Center for Pancreatic Disease, Brigham and Women's Hospital
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Pancreatic Diseases
- Pancreatitis
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Antiemetics
- Gastrointestinal Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Protease Inhibitors
- Dexamethasone
- Dexamethasone acetate
- BB 1101
Other Study ID Numbers
Other Study ID Numbers
- 2010P-002192
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