PANCREAS NEWS Glucocorticoids and Acute Pancreatitis: Suggestions for Future Clinical Trials

Corticosteroid administration for the treatment of acute pancreatitis is still being debated. In experimental acute pancreatitis, the results of this therapeutic option vary widely; some authors report an improvement of survival in different models of the disease in various animal species such as rats, rabbits, and dogs [1, 2, 3, 4] and others report an increase in the mortality rate after high-dose hydrocortisone treatment in rats with mild and severe disease, and a deteriorated outcome in hydrocortisone pre-treated rats with diet-induced acute pancreatitis [1, 2, 3, 4, 5]. Furthermore, a high-dose, long-term hydro-cortisone treatment of 2 weeks was associated with an increased infection or sepsis rate, thereby worsening the outcome of experimental acute pancreatitis [5], and in high-dose, short term hydrocortisone therapy, no benefit regarding survival was shown [6, 7, 8]. However, recently published papers showed promising results with moderate and low dose hydrocortisone treatment over a period varying from 7 to 14 days and these positive effects regard the ameliorated hemodynamic status, the reduced number of organ failures, and the increased incidence o