Ulinastatin Shows Promise in Severe Acute Pancreatitis Treatment, โMeta-Analysis Finds
A new systematic review and meta-analysis published in BMC Gastroenterology suggests ulinastatin treatment considerably improves several key outcomes inโ patientsโ with severe acute pancreatitis (SAP) compared โto standard of care (SoC). Researchers pooled data from multiple โคstudiesโ and โfoundโ ulinastatin was associated with a reduction in C-reactive protein (CRP) levels – a marker of inflammation – by a mean difference of โ7.77 mg/L (95% CI: โ11.31, โ4.23).
Theโ analysis alsoโ indicated aโข faster โคresolution of abdominal pain, with a meanโ difference of โ1.77 days โ(95% CI: โ2.18, โ1.36) favoring ulinastatin. Moreover, treatment withโ ulinastatin correlated with โsignificantly lower levels of tumor necrosis factor-ฮฑ (TNF-ฮฑ) – a pro-inflammatory cytokine – with a mean difference of โ15.75 pg/mL (95% CI:โ โ24.13, โ7.37), and serum โคinterleukin-6 (IL-6)โ levels, showing โขa mean difference of โ16.82 pg/mL (95% CI: โ29.31, โ4.34).Despite theseโฃ findings, the researchersโข noted considerable heterogeneityโฃ acrossโค studiesโฃ for CRP, TNF-ฮฑ, and IL-6 (I = 98%,โค 97%, and 96% respectively),โ and significantโค heterogeneityโ forโ time to โpain resolutionโค (I = 74%).โข Potential publication โคbias โขwas suggested byโฃ asymmetry โin the funnel plotโ for mortality, thoughโฃ caution was โadvised due to the โฃlimited number of studies.โ
The overall certainty โฃof evidence for all โฃoutcomes was rated as low, โprimarily due to the observational nature of the includedโฃ studiesโฃ andโ a serious risk of bias inโค several, โขparticularly โขregarding โฃcomparability between groups.