Pancreatitis Clinical Trial
Official title:
Multicenter, Double-bind, Randomised, Placebo Controlled Study of Ulinastatin in Severe Acute Pancreatitis
This study aims to evaluate the effect of ulinastatin in the treatment and prevention of organ failure in severe acute pancreatitis.
About 20% of patients with acute pancreatitis have a severe course, and 10-15% of those with
severe acute pancreatitis (SAP) die. Despite improvements in intensive care treatment during
past few decades, effective therapies for acute pancreatitis are still limited.
Early deaths (within the first week) due to severe acute pancreatitis are generally caused by
massive inflammatory responses which result in multiple organ failure. Although the exact
mechanisms which trigger the inflammatory processes are not completely understood, it is
generally accepted that autodigestion and activated leukocytes play important roles in the
pathogenesis of acute pancreatitis. Activation of digestive enzymes causes pancreatic injury
and results in an inflammatory response that is out of proportion to the response of other
organs to a similar insult. The acute inflammatory response itself causes substantial tissue
damage and may progress beyond the pancreas to a systemic inflammatory response syndrome,
multi organ failure, or death.
UTI is a multivalent Kunitz-type serine protease inhibitor that is found in human urine and
blood, it can stabilize lysosome membrane and inhibit lysosome function, inhibit the various
enzymes and inflammatory response. Previous study proved that it protects against SIRS
pathophysiology and subsequent organ damage induced via the modulation of the proinflammatory
mediator, as well as chemokines. UTI has been widely used for the treatment and prevention of
multiple organ failure in China, but there is few randomized, placebo controlled trial on
ulinastatin. A large multicenter, randomized study is warranted. In this study, we aim to
evaluate the effect of ulinastatin in the treatment and prevention of organ failure in severe
acute pancreatitis with regular treatment in an add-on trial.
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