The effect of ulinastatin on treatment of severe acute pancreatitis : a Meta-analysis

Abstract

Objective To evaluate the efficacy and the safety of Ulinastatin in treatment of severe acute pancreatitis. Methods A systematic review of randomized controlled trials (RCT) of Ulinastatin treatmen for severe acute pancreatitis was performed. The databases included Cochrane library controlled clinical trials database, PUBMED, EMBASE, China Biology Medicine disc, Wanfang Data were searched to date. Retrieval words were acute pancreatitis and Ulinastatin. Statistical processing using Review Manager 5.3 software provided by the Cochrane collaboration network. Results A total of 33 trials involving 1 786 patients were included, and all patients of the trials were not followed up at the end of the treatment. In the trials of Ulinastatin plus routine treatment vs routine treatment or placebo plus routine treatment,and 5 trials reported the fatality rate. Meta-analysis showed that the mortality rate in Ulinastatin group was lower than that in control group(RR = 0.29, 95%CI: 0.17-0.52, P < 0.01), and 16 trials used the total efficiency of treatment as outcome criteria. Meta-analysis results showed the total effective rate in the Ulinastatin group was significantly higher than that in control grouIn the trials of Ulinastatin plus routine treatment vs octreotide plus routine treatment, 9 trials used the total efficiency of treatment as outcome criteria. Meta-analysis results showed there was no statistically significant difference in total effective rate between Ulinastatin group and octreotide group. Conclusions Ulinastatin treatment was superior to conventional therapy in improving the short-term clinical efficacy of severe acute pancreatitis, and the mortality rate was lower than that in conventional treatment. But no obvious advantage was found in ulinastatin treatment compared with octreotide treatment. Key words: Ulinastatin; Severe acute pancreatitis; RCT; Meta analysis