Ulinastatin Shows Promise in Severe Acute Pancreatitis Treatment, Meta-Analysis Finds
A new systematic review and meta-analysis published in BMC Gastroenterology suggests ulinastatin treatment considerably improves several key outcomes in patients with severe acute pancreatitis (SAP) compared to standard of care (SoC). Researchers pooled data from multiple studies and found ulinastatin was associated with a reduction in C-reactive protein (CRP) levels – a marker of inflammation – by a mean difference of −7.77 mg/L (95% CI: −11.31, −4.23).
The analysis also indicated a faster resolution of abdominal pain, with a mean difference of −1.77 days (95% CI: −2.18, −1.36) favoring ulinastatin. Moreover, treatment with ulinastatin correlated with significantly lower levels of tumor necrosis factor-α (TNF-α) – a pro-inflammatory cytokine – with a mean difference of −15.75 pg/mL (95% CI: −24.13, −7.37), and serum interleukin-6 (IL-6) levels, showing a mean difference of −16.82 pg/mL (95% CI: −29.31, −4.34).Despite these findings, the researchers noted considerable heterogeneity across studies for CRP, TNF-α, and IL-6 (I = 98%, 97%, and 96% respectively), and significant heterogeneity for time to pain resolution (I = 74%). Potential publication bias was suggested by asymmetry in the funnel plot for mortality, though caution was advised due to the limited number of studies.
The overall certainty of evidence for all outcomes was rated as low, primarily due to the observational nature of the included studies and a serious risk of bias in several, particularly regarding comparability between groups.
