Short-Course Dexamethasone in Acute Pancreatitis: Preliminary Clinical and Biomarker Findings from a Pilot Study

Abstract

BACKGROUND. Acute pancreatitis (AP) is a clinically significant condition that can progress to a severe, life-threatening disease with substantial morbidity and mortality. Experimental studies in animal models have demonstrated beneficial effects of corticosteroid therapy on pancreatic inflammation and disease severity. In addition, several clinical studies in humans have reported promising results. However, the available evidence remains limited and inconclusive because of small sample sizes, heterogeneous study designs, and inconsistent outcomes. OBJECTIVES. The study analyzes the effectiveness of dexamethasone therapy in AP and its impact on clinical and laboratory parameters and length of hospital stay. The study aimed to compare these outcomes in patients treated with and without dexamethasone therapy. METHODS. A prospective, single-blind, pilot randomized clinical study was conducted, including 20 patients aged 45–85 years with moderately severe and severe acute pancreatitis treated at The First University Clinic, Simon Khechinashvili University Clinic, and The First Medical Center in Tbilisi, Georgia. Patients were randomly assigned (1:1) using a computer-generated randomization sequence generated with IBM SPSS Statistics version 23 (IBM Corp., Armonk, NY, USA) to receive either standard therapy (control, n=10) or adjunctive dexamethasone (0.5 mg/kg/day for 3 consecutive days) plus standard therapy (n=10). The primary endpoints were changes in serum pancreatitis-associated protein (PAP) and interleukin-6 (IL-6) levels from day 1 to day 5. Clinical outcomes and laboratory parameters, including procalcitonin, serum lipase, leukocyte count, and C-reactive protein (CRP), were also assessed. Statistical analyses included analysis of variance (ANOVA) for continuous variables and Fisher'sFisher's exact test for categorical variables. A two-sided p-value <0.05 was considered statistically significant. RESULTS. Patients in the control group had a longer hospital stay compared with those in the dexamethasone group (15.1±2.60 vs 12.3±1.77 days, respectively). No significant between-group differences were observed in CRP, IL-6, or procalcitonin levels during the early study period. However, by day 5 of hospitalization, the dexamethasone group demonstrated significantly lower CRP, IL-6, and procalcitonin levels compared with the control group. Increased PAP levels were also observed in the dexamethasone group, suggesting a possible effect on pancreatic tissue response and recovery. Serum lipase and leukocyte counts did not differ significantly between the groups. CONCLUSIONS. In this small preliminary pilot study, adjunctive dexamethasone was associated with shorter hospitalization and favorable day-5 trends in selected inflammatory markers. However, these findings should be interpreted with caution because of the small sample size. Larger, adequately powered randomized controlled trials are needed to confirm these preliminary findings and further evaluate the efficacy and safety of adjunctive dexamethasone in acute pancreatitis.