Dyrlægehuset Skanderborg, Ladegaardsbakken 16, 8660, Skanderborg, Denmark.
Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Dyrlægevej 16, 1870, Frederiksberg C, Denmark.
Acta Vet Scand. 2021 Jul 13;63(1):28. doi: 10.1186/s13028-021-00592-0.
Acute pancreatitis in dogs is a prevalent disease characterised by mild to severe inflammation. Treatment with anti-inflammatory corticosteroids has been widely debated but is not generally recommended in veterinary medicine. The objective of the present study was to present current evidence on the effect of corticosteroid treatment for acute/acute-on-chronic pancreatitis across species. These findings were then used to evaluate if and how corticosteroid treatment could influence disease outcome in canine acute/acute-on-chronic pancreatitis. A scoping review was performed by searching the Agricola, CAB Abstracts, MEDLINE and Embase databases to identify relevant articles published before June 24, 2021. The inclusion criteria were English language, original research published in a peer-reviewed journal, and investigation of corticosteroid treatment effects on acute/acute-on-chronic pancreatitis by the outcome parameters clinical score, circulating CRP level, hospitalisation duration, mortality and pancreas histopathology. Research on any species was considered. Studies were rated based on the level of evidence, and methodological quality was evaluated based on similarity between groups at baseline, risk of bias and study group size. The reporting method was based on the PRISMA extension for scoping reviews. One thousand nine hundred fifty-four studies were identified, and 31 met the inclusion criteria. Five were canine studies, with 4 investigating experimentally induced pancreatitis; 5 were human clinical studies; and 21 were rodent studies of experimentally induced pancreatitis. The level of evidence ranged between randomised controlled trials and case series, the estimated risk of bias ranged from low to high, and the sample sizes ranged from very small to moderate. Evidence indicates that adding corticosteroid to symptomatic treatment of acute/acute-on-chronic canine pancreatitis could have a positive influence on disease outcome. However, the analysed evidence was based on several species, including both naturally occurring and experimentally induced pancreatitis; thus, the authors suggest that large randomised controlled studies should be performed in dogs with spontaneously occurring acute/acute-on-chronic pancreatitis to further elucidate a potential benefit of corticosteroid treatment.
犬急性胰腺炎是一种常见疾病，其特征为轻度至重度炎症。抗炎皮质类固醇的治疗已广泛争论，但在兽医医学中通常不推荐。本研究的目的是介绍目前关于皮质类固醇治疗急性/急性慢性胰腺炎在不同物种中的效果的证据。然后，这些发现被用来评估皮质类固醇治疗是否以及如何影响犬急性/急性慢性胰腺炎的疾病结局。通过搜索 Agricola、CAB 摘要、MEDLINE 和 Embase 数据库，进行了范围综述，以确定截至 2021 年 6 月 24 日之前发表的相关文章。纳入标准为英语、在同行评议期刊上发表的原始研究、以及通过临床评分、循环 CRP 水平、住院时间、死亡率和胰腺组织病理学等结局参数调查皮质类固醇治疗对急性/急性慢性胰腺炎的影响。考虑了任何物种的研究。根据证据水平对研究进行评分，并根据基线时组间的相似性、偏倚风险和研究组大小评估方法学质量。报告方法基于扩展后的 PRISMA 用于范围综述。确定了 1954 项研究，其中 31 项符合纳入标准。其中 5 项为犬研究，其中 4 项研究实验性诱导胰腺炎；5 项为人类临床研究；21 项为实验性诱导胰腺炎的啮齿动物研究。证据水平介于随机对照试验和病例系列之间，估计的偏倚风险从低到高不等，样本量从非常小到中等不等。证据表明，在急性/急性慢性犬胰腺炎的对症治疗中添加皮质类固醇可能对疾病结局产生积极影响。然而，分析的证据基于几种物种，包括自然发生和实验性诱导的胰腺炎；因此，作者建议在自发性发生急性/急性慢性胰腺炎的犬中进行大型随机对照研究，以进一步阐明皮质类固醇治疗的潜在益处。
