Gabexate mesilate vs aprotinin in human acute pancreatitis (GA.ME.P.A.)

Pederzoli, Paolo; Cavallini, Giorgio; Falconi, Massimo; Bassi, Claudio

doi:10.1007/bf02786117

Cited by 60 publications

(4 citation statements)

References 19 publications

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“…The 2 main compounds described in the literature to inhibit this enzyme activation include the serine protease inhibitor gabexate mesilate and the trypsin inhibitor aprotinin. In 1993, Pederzoli et al (166) reported results of a randomized, double-blind multicenter clinical trial on use of gabexate mesilate versus aprotinin in AP therapy. In this study, gabexate mesilate appeared more favorable to aprotinin for the period 24 to 72 hours, but importantly, a placebo control arm is missing.…”

Section: F Use Of Protease Inhibitors In Pediatric Acute Pancreatitismentioning

confidence: 99%

“…In this study, gabexate mesilate appeared more favorable to aprotinin for the period 24 to 72 hours, but importantly, a placebo control arm is missing. Timing of treatment and mode of delivery seem to be key factors in efficacy (166,167). Ino et al studied the efficacy of continuous regional artery infusion CRAI with gabexate mesilate and antibiotics for severe AP via a small prospective study involving 9 patients receiving CRAI for 3 to 5 days and 9 others receiving systemic protease inhibitor therapy and antibiotics.…”

Section: F Use Of Protease Inhibitors In Pediatric Acute Pancreatitismentioning

confidence: 99%

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Management of Acute Pancreatitis in the Pediatric Population

Abu‐El‐Haija

Kumar²,

Quiros

et al. 2018

J. pediatr. gastroenterol. nutr.

195

160

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Section: F Use Of Protease Inhibitors In Pediatric Acute Pancreatitismentioning

confidence: 99%

Section: F Use Of Protease Inhibitors In Pediatric Acute Pancreatitismentioning

confidence: 99%

Management of Acute Pancreatitis in the Pediatric Population

Abu‐El‐Haija

Kumar²,

Quiros

et al. 2018

J. pediatr. gastroenterol. nutr.

195

160

View full text Add to dashboard Cite

show abstract

“…Despite the lack of evidence for benefit by either drug, Pederzoli and colleagues [19] compared aprotinin to gabexate mesilate in 199 patients with pancreatitis. Because a Ranson score > 2 was required for inclusion, most of the patients had severe disease.…”

Section: Early Medical Therapies With No Efficacymentioning

confidence: 99%

Acute pancreatitis: Nonsurgical management

Tenner

Banks

1997

World j. surg.

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The care of patients with severe acute pancreatitis is complex. Although numerous medical therapies have been proposed, few interventions have been shown to be of benefit in patients with severe disease. This review summarizes the nonoperative management of patients with acute pancreatitis, including therapies shown to be of little value, the role of antibiotics in patients with acute pancreatitis, the importance of monitoring and supportive care, and the rationale of endoscopic and surgical intervention.

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“…11,12) Gabexate mesilate (Foy Ⓡ ), a synthetic protease inhibitor used as an anticoagulant, has been found the effective in the treatment of acute pancreatitis and disseminated intravascular coagulation (DIC) due to sepsis in human and in an animal model of sepsis. [13][14][15] This drug not only inhibits the function of thrombin, plasmin, kallikrein, trypsin, and neutrophil elastase but also suppresses the adhesion and activation of the neutrophil. 16,17) Ulinastatin, hydrolase inhibitor, suppress IL-8 release during one lung anesthesia in surgery.…”

mentioning

confidence: 99%

Effects of Gabexate Mesilate (Foy^®) on Endotoxin-Induced Acute Lung Injury in Rabbit

Kwak

Jung

Choi

et al. 2005

Korean J Anesthesiol

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Acute respiratory distress syndrome (ARDS) is a complex syndrome of intense pulmonary inflammatory response with high morbidity and mortality, and is characterized by neutrophil accumulation, interstitial edema, disruption of epithelial integrity, and leakage of protein into the alveolar space that are associated with severe alterations in gas exchange. 1) The mortality remains in the range of 30 to 70%, similar to that in seventies when the disease was first described despite of recent advances in intensive care. [2][3][4] The most common cause of ARDS is well known to be sepsis. 5,6)The precise pathogenesis for sepsis induced ARDS is not yet fully defined. However, massive accumulation of neutrophils in the lung and increased pulmonary pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF -α), interleukin (IL) -1β, IL-6, and IL-8 are major features of ARDS. These mediators have been suggested to play important roles in the initiation and progression of ARDS. [7][8][9][10] The activation of the neutrophils within the lung causes microvascular injury, attributed to the release of neutrophil proteases and reactive oxygen species (ROS). 11,12) Gabexate mesilate (Foy Ⓡ ), a synthetic protease inhibitor used as an anticoagulant, has been found the effective in the treatment of acute pancreatitis and disseminated intravascular coagulation (DIC) due to sepsis in human and in an animal model of sepsis. [13][14][15] This drug not only inhibits the function of thrombin, plasmin, kallikrein, trypsin, and neutrophil elastase but also suppresses the adhesion and activation of the neutrophil. 16,17) Ulinastatin, hydrolase inhibitor, suppress IL-8 release during one lung anesthesia in surgery. 18) And it also prevents platelet aggregations in patients with DIC or sepsis. 14)Thus, these effects of Foy Ⓡ may be advantageous in certain conditions such as acute lung injury due to sepsis.The major aim of this study was to evaluate whether theseBackground: This study was to clarify the effects of gabexate mesilate (Foy Ⓡ ), a synthetic protease inhibitor, on endotoxin induced acute lung injury in rabbit. Methods: Animals were randomly assigned to one of four groups: saline only (n = 7), saline and Escherichia coli endotoxin 5 mg/kg over 30 mins (n = 7), Foy Ⓡ 1 mg/kg bolus, followed by infusion of Foy Ⓡ at 1 mg/kg/h and endotoxin (n = 7), Foy Ⓡ 2 mg/kg bolus, followed by infusion of Foy Ⓡ at 2 mg/kg/h and endotoxin (n = 7). Infusion of saline or Foy Ⓡ was started 0.5 hour before the start of infusion of saline or endotoxin and continued for 6.5 hours. At the end infusion animals were sacrificed, and the wet to dry (W/D) weight ratio of lung, lung injury score and leukocyte counts, percentage of polymorphonuclear leukocyte (PMNL), and concentrations of albumin and interleukin-8 (IL-8) in bronchoalveolar lavage fluid (BALF) were evaluated.Results: Endotoxin decreased the PaO2 and peripheral blood leukocyte and platelet counts. And it increased the W/D weight ratio of lung, lung injury score and leukocyte counts, percenta...

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Gabexate mesilate vs aprotinin in human acute pancreatitis (GA.ME.P.A.)

Cited by 60 publications

References 19 publications

Management of Acute Pancreatitis in the Pediatric Population

Management of Acute Pancreatitis in the Pediatric Population

Acute pancreatitis: Nonsurgical management

Effects of Gabexate Mesilate (Foy^®) on Endotoxin-Induced Acute Lung Injury in Rabbit

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Gabexate mesilate vs aprotinin in human acute pancreatitis (GA.ME.P.A.)

Cited by 60 publications

References 19 publications

Management of Acute Pancreatitis in the Pediatric Population

Management of Acute Pancreatitis in the Pediatric Population

Acute pancreatitis: Nonsurgical management

Effects of Gabexate Mesilate (Foy®) on Endotoxin-Induced Acute Lung Injury in Rabbit

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Product

Resources

About

Effects of Gabexate Mesilate (Foy^®) on Endotoxin-Induced Acute Lung Injury in Rabbit