Dynastat (parecoxib) / Pfizer - LARVOL DELTA

INHIBITION OF PANCREATIC ENDOTHELIAL CYCLOOXYGENASE-2 AMELIORATED SEVERE ACUTE PANCREATITIS (UEGW 2026) - "The single-center randomized controlled trial has demonstrated that early administration of selective COX-2 inhibitors (parecoxib sequential with celecoxib) in high-risk patients for SAP reduced the occurrence of SAP by approximately 47% and lowered local complications such as pancreatic necrosis by nearly 45% [7]. Recently, a well-designed multicenter randomized controlled trial validated the significant efficacy and safety of parecoxib sequential with imrecoxib in prevention and treatment of SAP [8], providing high-level favorable evidence for early anti-inflammatory intervention with COX-2 inhibitors... Over-expression of COX-2 in pancreatic endothelia at the onset of AP may deteriorate AP through attraction of a great number of neutrophils, pancreatic endothelial senescence, degeneration of mitochondria and thrombosis formation in pancreatic microcirculation. Down-regulation of COX-2 expression with COX-2 inhibitors as early as possible may be benefit for prevention..."

Cardiovascular • Hematological Disorders • Inflammation • Pancreatitis • Respiratory Diseases • Thrombosis • CDKN1A • CXCL1 • CXCL8 • ICAM1 • PACERR • PTGS2 • TNFA • VCAM1

QSAR-Guided Virtual Screening and Molecular Dynamics Reveal Olaparib as a Repurposing Lead Against α-Synuclein Aggregation. (PubMed, Int J Mol Sci) - "The top docking candidates were Olaparib (-7.91 kcal/mol), Paliperidone (-7.75 kcal/mol), Niraparib (-7.18 kcal/mol), Dordaviprone (-7.06 kcal/mol), and Parecoxib (-6.89 kcal/mol). These findings identify Olaparib as a novel high-affinity repurposing lead, while Paliperidone and Risperidone are reported as chemically informative secondary NAC-groove binders rather than proposed antiparkinsonian therapeutics, given that their dopamine D2-antagonist pharmacology is clinically associated with drug-induced parkinsonism. All of the candidates warrant experimental validation via thioflavin-T fluorescence or nuclear magnetic resonance (NMR) spectroscopy."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Analysis of the safety and efficacy of Parecoxib sodium in the treatment of acute pancreatitis (ChiCTR) - P=N/A | N=198 | Completed | Sponsor: ShangRao People's Hospital; ShangRao People's Hospital

New trial • Pancreatitis

Preemptive nalbuphine combined with subcostal transversus abdominis plane block for multimodal analgesia in laparoscopic liver resection: a randomized controlled trial of multimodal analgesia for laparoscopic hepatectomy. (PubMed, Clinics (Sao Paulo)) - "The regimen combining preemptive nalbuphine with subcostal TAPB was associated with better postoperative analgesia, more stable perioperative hemodynamics, and fewer opioid-related adverse events than no regional block and represents a feasible multimodal analgesia strategy for LLR. Because the control group did not receive a sham TAPB, the specific pharmacological contribution of TAPB alone cannot be isolated from a procedural placebo effect."

Journal • Dermatology • Pain • Pruritus

Preemptive analgesia with parecoxib sodium alleviates short-term pain after endoscopic submucosal dissection for early esophageal cancer and precancerous lesions: a single-center, double-arm, and randomized controlled study. (PubMed, Front Oncol) - P4 | "The frequency and total dosage of postoperative tramadol administration, as well as the incidence of adverse reactions, were comparable between the two groups (all P > 0.05). Preemptive analgesia with parecoxib sodium can alleviate early postoperative pain in patients with early esophageal cancer and precancerous lesions who undergo ESD for mucosal defects involving less than three-quarters of the esophageal circumference, without increasing adverse reactions or the subsequent use of analgesic drugs. https://www.chictr.org.cn/showproj.html?proj=218572, identifier ChiCTR2400080433."

Clinical • Journal • Anesthesia • Esophageal Cancer • Oncology • Pain • CRP • IL6

PARISAH: Evaluation of the Safety and Efficacy of Parecoxib in Patients With Subarachnoid Hemorrhage (clinicaltrials.gov) - P2 | N=112 | Recruiting | Sponsor: St. Anne's University Hospital Brno, Czech Republic | Not yet recruiting ➔ Recruiting

Enrollment open • Hematological Disorders • Subarachnoid Hemorrhage

Effects of Preemptive Analgesia Using Wrist-Ankle Acupuncture on Postoperative Pain and Urinary Retention After Haemorrhoidectomy: A Randomised, Three-Arm, Clinical Trial. (PubMed, J Pain Res) - P1 | "In patients stratified by types of basic analgesics (Med1 (Flurbiprofen Esters Injection) and Med2 (Parecoxib sodium for injection) subgroups), the preemptive analgesia group consistently showed significantly lower VAS scores (P < 0.01). It represents a promising non-pharmacological adjunct for multimodal perioperative care; however, multi-centre trials are needed to confirm its generalisability before routine adoption. ChiCTR2400084402."

Clinical • Journal • Gastroenterology • Pain • MBD4 • MED1

Tegaserod combined with different non-steroidal drugs for postoperative analgesia after laparoscopic cholecystectomy: a 22 factorial randomized controlled trial (ChiCTR) - P4 | N=428 | Not yet recruiting | Sponsor: Shanghai East Hospital; Shanghai East Hospital

New P4 trial • Respiratory Diseases

Factors Associated with the Early Ambulation After Elective Lumbar Spinal Surgery: A Retrospective Cohort Study. (PubMed, J Clin Med) - " EA after elective lumbar spinal fusion was associated with better postoperative recovery. Factors independently associated with EA included lower ASA class, shorter anesthetic duration, and postoperative intravenous parecoxib use."

Journal • Retrospective data • Anesthesia • Orthopedics

Involvement of COX-2 in the Neurovascular Unit Damage Through Up-Regulating Calpain/PARP/NF-κB Inflammatory Signaling During Ischemic Stroke. (PubMed, Neurochem Res) - "These data demonstrated that parecoxib exerts its protective effects on the NVU by blocking the over-activation of calpain and PARP, as well as by suppressing NF-κB-mediated inflammatory response during ischemic stroke. Moreover, the findings suggest that COX-2 contributes to NVU damage by up-regulating the calpain/PARP/NF-κB inflammatory pathway during brain ischemia."

Journal • Cardiovascular • Inflammation • Ischemic stroke • CAPN1 • HMGB1 • ICAM1 • IL1B • MMP2 • MMP9 • NFKBIA

PEARL: Pre-Emptive Parecoxib Sodium for Pain Control During CT-Guided Lung Nodule Localization (clinicaltrials.gov) - P4 | N=150 | Recruiting | Sponsor: Long Jiang

New P4 trial • Pain

Effect of COX-2 inhibitor (parecoxib) versus placebo on opioid pain medication use after bariatric surgery: a randomised controlled trial (ANZCTR) - P=N/A | N=174 | Not yet recruiting | Sponsor: Te Whatu Ora Waitemata

New trial • Genetic Disorders • Obesity • Pain

Targeting MEF2A suppresses microglial hyperactivation and synaptic phagocytosis to attenuate epilepsy pathogenesis. (PubMed, Cell Death Dis) - "Targeting microglial MEF2A with parecoxib or AAV knockdown reduced seizure severity and cognitive deficits and maintained synaptic inhibition by reducing excessive microglial phagocytosis. This reveals an ATP-P2X7-Ca2⁺- MEF2A signaling axis connecting neuronal injury with pathogenic microglial activation, suggesting MEF2A as a therapeutic target for microglial-neuronal homeostasis restoration in epilepsy pathology."

Journal • CNS Disorders • Cognitive Disorders • Epilepsy • Inflammation • CD74 • HDAC5 • NLRP3

Nursing care of an elderly patient with toxic epidermal necrolysis: a case report. (PubMed, Front Med (Lausanne)) - "This paper summarizes the ICU nursing experience of an 84-year-old female patient with TEN presumably induced by parecoxib injection...Her recovery duration was shorter than the average for similar patients, and no severe ocular complications developed. This case demonstrates that a comprehensive nursing strategy incorporating staged wound care, multidimensional mucosal protection, individualized intravenous access management, and full-process infection control can effectively reduce complication risks, accelerate wound healing, and improve outcomes in elderly patients with severe TEN, providing a reference for clinical nursing practice in this vulnerable population."

Journal • Critical care • Immunology • Infectious Disease • Musculoskeletal Diseases • Orthopedics • Steven-Johnson Syndrome • EGF

Efficacy of Different Analgesic Techniques on Postoperative Opioid Consumption and Pain After Pancreaticoduodenectomy: A Systematic Review and Network Meta-Analysis. (PubMed, World J Surg) - "Compared with epidural block, intravenous parecoxib was ranked as the most effective intervention for reducing postoperative opioid consumption. WI, TAP block, electrical muscle stimulation, and ITM + TAP also demonstrated superior effects in reducing opioid consumption relative to epidural analgesia. Regarding secondary outcomes, intravenous parecoxib was the most effective in reducing postoperative pain scores at rest, while both WI and intravenous acetaminophen were associated with a lower incidence of PONV. These findings suggest that alternative analgesic strategies, particularly intravenous parecoxib, may offer advantages over epidural block. Given the limited number of studies currently included, these conclusions need to be further validated by future high-quality research."

Journal • Retrospective data • Pain

PI2025_843_0004: Evaluation of postoperative recovery when combining intravenous lidocaine with ropivacaine infiltration in laparoscopic colorectal oncologic surgery: a randomized controlled trial (clinicaltrialsregister.eu) - P4 | N=182 | Recruiting | Sponsor: Centre Hospitalier Universitaire Amiens Picardie | Not yet recruiting ➔ Recruiting

Enrollment open • Colorectal Cancer • Oncology • Solid Tumor

Pre-surgical medical interventions for treatment of pediatric post-tonsillectomy pain: A Systematic Review and Meta-Analysis (COSM 2026) - "IV and PO acetaminophen, IM diclofenac, INF ketamine, IV lidocaine, PO midazolam, IM papaveretum, IV parecoxib, IM and IV pethidine, INF ropivacaine, IM tenoxicam, and IV and INF tramadol showed no difference from placebo in percentage of patients requiring rescue analgesia. A total of 2,952 articles were screened, and 75 RCTs met inclusion criteria. Patients receiving IV or INF dexmedetomidine had the longest time to request additional analgesia post-surgically (µ = 583.45 minutes, 95% CI [524.9, 641.2] and µ = 537.6 minutes, 95% CI [498.3, 576.9], respectively), followed by INF levobupivacaine (µ = 460.98 min, 95% CI [281.9, 640.0]). IV ketamine or INF levobupivacaine demonstrated the shortest time to resumption of oral intake (µ = 127.452 minutes, 95% CI [41.1, 213.8], and µ = 126.2 minutes, 95% CI [108.4, 143.9] respectively)."

Retrospective data • Review • Pain • Pediatrics

Efficacy of paraxib in the prevention and treatment of severe hypertriglyceridemia-associated pancreatitis (ChiCTR) - P=N/A | N=156 | Sponsor: The first affiliated hostipal of nanchang university; The first affiliated hostipal of nanchang university

New trial • Dyslipidemia • Hypertriglyceridemia • Pancreatitis • Severe Hypertriglyceridemia

Effect of parecoxib on postoperative anxiety and cognitive function after pancreaticoduodenectomy: A clinical trial. (PubMed, Medicine (Baltimore)) - "Parecoxib, when used with pancreaticoduodenectomy, alleviates postoperative anxiety and neurocognitive disorders without affecting postoperative intestinal function recovery or increasing the incidence of postoperative complications."

Clinical • Journal • Alzheimer's Disease • Anesthesia • CNS Disorders • Cognitive Disorders • Developmental Disorders • Pain • Psychiatry

Pre-surgical medical interventions for treatment of pediatric post-tonsillectomy pain: A Systematic Review and Meta-Analysis (COSM 2026) - "IV and PO acetaminophen, IM diclofenac, INF ketamine, IV lidocaine, PO midazolam, IM papaveretum, IV parecoxib, IM and IV pethidine, INF ropivacaine, IM tenoxicam, and IV and INF tramadol showed no difference from placebo in percentage of patients requiring rescue analgesia. A total of 2,952 articles were screened, and 75 RCTs met inclusion criteria. Patients receiving IV or INF dexmedetomidine had the longest time to request additional analgesia post-surgically (µ = 583.45 minutes, 95% CI [524.9, 641.2] and µ = 537.6 minutes, 95% CI [498.3, 576.9], respectively), followed by INF levobupivacaine (µ = 460.98 min, 95% CI [281.9, 640.0]). IV ketamine or INF levobupivacaine demonstrated the shortest time to resumption of oral intake (µ = 127.452 minutes, 95% CI [41.1, 213.8], and µ = 126.2 minutes, 95% CI [108.4, 143.9] respectively)."

Retrospective data • Review • Pain • Pediatrics

PI2025_843_0004: Evaluation of postoperative recovery when combining intravenous lidocaine with ropivacaine infiltration in laparoscopic colorectal oncologic surgery: a randomized controlled trial (clinicaltrialsregister.eu) - P4 | N=182 | Not yet recruiting | Sponsor: Centre Hospitalier Universitaire Amiens Picardie

New P4 trial • Colorectal Cancer • Oncology • Solid Tumor

Efficacy of intravenous parecoxib in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: a randomized controlled trial. (PubMed, Surg Endosc) - "Intravenous parecoxib was effective in reducing post-ERCP abdominal pain and showed a trend toward a lower incidence of post-ERCP pancreatitis (PEP) in both unselected and high-risk patients, without any serious adverse events. Therefore, intravenous parecoxib may represent a viable alternative for PEP prevention in settings where rectal nonsteroidal anti-inflammatory drugs are unavailable."

Journal • Pain • Pancreatitis

Effect of preventive precision multimodal analgesia (PPMA) on postoperative acute pain process and rehabilitation in adult patients undergoing thoracoscopic pulmonary resection: protocol for a prospective, multicentre, randomised controlled study. (PubMed, BMJ Open) - P=N/A | "Patients in the PPMA Group will receive a regimen consisting of local anaesthetic infiltration of surgical incision (for incisional pain), intravenous injection of oxycodone (for visceral pain) and parecoxib sodium (for inflammatory pain) before surgery initiation...The results will be published in a peer-reviewed journal. Chinese Clinical Trial Registry (ChiCTR2300072176)."

Clinical protocol • Journal • Anesthesia • Pain

Effectiveness of drug interventions to prevent delirium after surgery for older adults: systematic review and network meta-analysis of randomised controlled trials. (PubMed, BMJ) - "Dexmedetomidine is effective in the prevention of postoperative delirium. This finding remains after exclusion of studies at high risk of bias. Corticosteroids, melatonin receptor agonists, parecoxib, intranasal insulin, and olanzapine have potential benefit, although evidence is of moderate to very low quality. Evidence synthesis in this area is complicated by inadequate trial registration practices and incomplete adoption of core outcome sets."

Clinical • Journal • Retrospective data • Review • Anesthesia • Cardiovascular • CNS Disorders • Hypotension • Infectious Disease

Comparison of Tegileridine and Sufentanil for Multimodal Analgesia in Gynecological Laparoscopic Surgery: A Randomized Double-blinded Controlled Trial (ChiCTR) - P=N/A | N=168 | Not yet recruiting | Sponsor: Obstetrics and Gynecology Hospital, Fudan University; Obstetrics & Gynecology Hospital of Fudan University, Shanghai Key Lab of Reproduction and D

New trial • Pain