Penta-therapy for severe acute hyperlipidemic pancreatitis

Lü, Jian; Xie, Yun; Du, Jiang; Kang, Mei; Jin, Wei; Li, Yan; Xie, Hui; Cheng, Ruijie; Tian, Rui; Wang, Ruilan

doi:10.1016/j.ajem.2018.01.092

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…The main characteristics of the studies are listed in Table 1 14,20‐33 . The included studies were published between 2004 and 2022, and most were historical cohort studies.…”

Section: Resultsmentioning

confidence: 99%

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Plasmapheresis compared with conventional treatment for hypertriglyceridemia‐induced acute pancreatitis: A systematic review and meta‐analysis

Yan

Chen

et al. 2022

J of Clinical Apheresis

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Background The treatment of acute pancreatitis (AP) induced by hypertriglyceridemia (HTG) remains controversial with regard to plasmapheresis vs conventional treatment. We reviewed relevant articles to explore the efficacy of plasmapheresis in the management of HTG‐induced AP. Methods We systematically reviewed studies that compared plasmapheresis with conventional treatment for HTG‐induced AP using three databases: PubMed, Embase, and Cochrane Library, as well as relevant references. The primary outcomes were 24 h triglyceride reduction rate and in‐hospital mortality. Results A total of 791 articles were retrieved. Finally, 15 observational studies (1080 participants) were included, most of which were historical cohort studies. Compared with conventional treatment, plasmapheresis assisted in the reduction of serum triglyceride (TG) levels in the first 24 h after hospital admission (standardized mean difference [SMD]: 0.58; 95% confidence interval [CI]: 0.17 to 0.99; P = 0.005). However, it resulted in increased hospitalization costs (thousand yuan) (weighted mean difference [WMD]: 24.32; 95% CI: 12.96 to 35.68; P < 0.001). With regard to in‐hospital mortality, although the mortality rate in the plasmapheresis group was higher than that in the conventional treatment group (relative risk [RR]: 1.74; 95% CI: 1.03 to 2.94; P = 0.038), the result was disturbed by confounding factors as per the subgroup and sensitivity analysis, as well as trial sequential analysis (TSA). No significant differences were found in other outcomes, including systematic complications, local complications, the requirement for surgery, and hospitalization duration. Conclusion The effect of plasmapheresis in HTG‐induced AP is not superior to that of conventional treatment, even resulting in a greater economic burden to patients and health care system. High quality randomized control trials are required to obtain a more a definitive understanding of this issue.

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“…The main characteristics of the studies are listed in Table 1 14,20‐33 . The included studies were published between 2004 and 2022, and most were historical cohort studies.…”

Section: Resultsmentioning

confidence: 99%

“…The main characteristics of the studies are listed in Table 1. 14,[20][21][22][23][24][25][26][27][28][29][30][31][32][33] The included studies were published between 2004 and 2022, and most were historical cohort studies. Our search showed no published RCTs on this topic.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Plasmapheresis compared with conventional treatment for hypertriglyceridemia‐induced acute pancreatitis: A systematic review and meta‐analysis

Yan

Chen

et al. 2022

J of Clinical Apheresis

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“…At present, low-molecular-weight heparin has been clinically applied to the treatment of HGT-AP [15]. Low-molecular-weight heparin can promote the hydrolysis of chylomicron and inhibit the release of 5-hydroxytryptamine and other substances from platelets, to reduce serum TG levels and exert anti-inflammatory effects [16].…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of low-molecular-weight heparin combined with insulin in the treatment of hypertriglyceridemic acute pancreatitis

Liying

2023

Japanese J Gastroenterol Res

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“…Early prediction of disease severity is also important for the treatment and prognostic evaluation of HTGAP (28), as the progression of HTGAP is often rapid. Distinguishing HTG-MAP and HTG-SAP is important for the treatment and control of HTGAP (29). At present, the most common methods used to predict AP are the APACHE II and Ranson scoring systems (30).…”

Section: Discussionmentioning

confidence: 99%

Increased levels of miR‑372 correlate with disease progression in patients with hyperlipidemic acute pancreatitis

et al. 2020

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The aim of the present study was to investigate the expression of microRNA (miRNA)-372 in the serum of patients with hyperlipidemic acute pancreatitis (HTGAP), and its clinical significance. Patients with a serum lipid concentration ≥11.3 or 5.65-11.3 mmol/l with chylous serum were included in group A (n=40). The remaining patients did not have HTGAP and were included in group B (B). A further 25 patients with hyperlipidemia, but not AP (group C), and 30 healthy volunteers (group D) were recruited as controls. The level of miR-372 in the serum of group A (4.76±2.60) was significantly increased compared with groups B (0.98±0.80), C (0.85±0.62) and D (0.76±0.44); however, there was no significant difference in the expression of miR-372 between groups B, C and D. The expression level of miR-372 was significantly increased in the severe HTGAP group (6.45±2.20) compared with the mild HTGAP group (3.08±1.74). Further experiments suggested that the expression level of miR-372 was positively correlated with the level of triacylglycerol (r= 0.666; P<0.001) but not with the level of amylase (r=-0.145; P>0.05). ROC analysis indicated that the combined use of miR-372 expression levels and Acute Physiology and Chronic Health Evaluation II scoring improved the diagnostic value for HTGAP. In summary, the expression of miR-372 in HTGAP was significantly upregulated and increased with the severity of the disease. The results of the present study may provide a novel strategy for the diagnosis and severity assessment of HTGAP in the clinic.

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Penta-therapy for severe acute hyperlipidemic pancreatitis

Cited by 10 publications

References 22 publications

Plasmapheresis compared with conventional treatment for hypertriglyceridemia‐induced acute pancreatitis: A systematic review and meta‐analysis

Plasmapheresis compared with conventional treatment for hypertriglyceridemia‐induced acute pancreatitis: A systematic review and meta‐analysis

Clinical efficacy of low-molecular-weight heparin combined with insulin in the treatment of hypertriglyceridemic acute pancreatitis

Increased levels of miR‑372 correlate with disease progression in patients with hyperlipidemic acute pancreatitis

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