Treatment of Acute Pancreatitis with Trasylol: Report of a Controlled Therapeutic Trial

Treatment of acute pancreatitis with protease inhibitors administered through intravenous infusion: an updated systematic review and meta-analysis

“…In the previous analysis [10], five [34,43,44,47,49] of 10 selected articles [31,33,34,37,42-44,46,47,49] were with CMR >0.10 and showed limited effectiveness. In the present analysis, 10 [27,28,34-36,41,43,44,47,49] of 17 selected articles were with CMR >0.10 and showed no significant effectiveness. On the other hand, the subgroup analysis of articles with CMR >0.20 [34,49] revealed a significant therapeutic effect.…”

“…Of the 17 articles, 11 [29-31,33-36,41,42,44,46,47] were conducted in a multicenter setting, and six [27,28,32,37,42,49] in a single-center setting. Sixteen articles were published as a full paper [27-29,31-37,41-43,46,47], and one as an abstract only [44].…”

The management of severe acute pancreatitis

“…Despite the inherent difficulties in conducting a clinical trial in acute pancreatitis, we believe that trasylol is a useful adjunct in the treatment of the condition provided the drug is given early in the attack in the augmented dose of 150,000-300,000 units/day. The importance of this dosage schedule was demonstrated in an in vitro study and in a controlled clinical trial carried out in thirty-two of the patients in the present series (Moshal et al, 1963) and may explain the equivocal results obtained in centres in which dosages of 30,000-50,000 units/day were employed (Skyring, Singer & Tornya, 1965). While our data do not permit a definite conclusion to be drawn regarding the efficacy of trasylol in the fulminating and potentially lethal case of acute pancreatitis, there was little doubt regarding its value in reducing the duration of pain and hypertrypsinaemia in the average acute attack.…”

Benefit of continuous regional arterial infusion of protease inhibitor and antibiotic in the management of acute necrotizing pancreatitis

“…Accordingly, protease inhibitor has been expected to act as a key factor in the therapeutic approach to the pancreas. Although protease inhibitor did not affect the mortality rate in randomized controlled trials [1][2][3][4][5][6][7][8], meta-analysis demonstrated that protease inhibitor reduced complications in severe acute pancreatitis [9]. Prophylactic antiprotease therapy also reduced the incidence of post-ERCP acute pancreatitis [10][11].…”