Continuous Regional Arterial Infusion of Protease Inhibitors Has No Efficacy in the Treatment of Severe Acute Pancreatitis: A Retrospective Multicenter Cohort Study

Masayasu Horibe, Mitsuhito Sasaki, Masamitsu Sanui, Daisuke Sugiyama, Eisuke Iwasaki, Yoshiyuki Yamagishi, Hirotaka Sawano, Takashi Goto, Tsukasa Ikeura, Tsuyoshi Hamada, Takuya Oda, Hideto Yasuda, Wataru Shinomiya, Dai Miyazaki, Kaoru Hirose, Katsuya Kitamura, Nobutaka Chiba, Tetsu Ozaki, Takahiro Yamashita, Toshitaka KoinumaTaku Oshima, Tomonori Yamamoto, Morihisa Hirota, Takashi Moriya, Kunihiro Shirai, Toshihiko Mayumi, Takanori Kanai

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective The aim of this study is to assess the effectiveness of continuous regional arterial infusion (CRAI) of protease inhibitors in patients with severe acute pancreatitis (SAP) including acute necrotizing pancreatitis. Methods This retrospective study was conducted among 44 institutions in Japan from 2009 to 2013. Patients 18 years or older diagnosed with SAP according to the criteria of the Japanese Ministry of Health, Labour and Welfare study group (2008) were consecutively enrolled. We evaluated the association between CRAI of protease inhibitors and mortality, incidence of infection, and the need for surgical intervention using multivariable logistic regression analysis. Results Of 1159 patients admitted, 1097 patients with all required data were included for analysis. Three hundred and seventy-four (34.1%) patients underwent CRAI of protease inhibitors and 723 (65.9%) did not. In multivariable analysis, CRAI of protease inhibitors was not associated with a reduction in mortality, infection rate, or need for surgical intervention (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.47-1.32, P = 0.36; OR 0.97, 95% CI 0.61-1.54, P = 0.89; OR 0.76, 95% CI 0.50-1.15, P = 0.19; respectively). Conclusions Continuous regional arterial infusion of protease inhibitors was not efficacious in the treatment of patients with SAP.

Original languageEnglish
Pages (from-to)510-517
Number of pages8
JournalPancreas
Volume46
Issue number4
DOIs
Publication statusPublished - 2017 Apr 1

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Intra Arterial Infusions
Protease Inhibitors
Pancreatitis
Multicenter Studies
Cohort Studies
Odds Ratio
Confidence Intervals
Acute Necrotizing Pancreatitis
Mortality
Infection
Japan
Retrospective Studies
Logistic Models
Regression Analysis
Incidence
Health

Keywords

  • acute necrotizing pancreatitis
  • continuous regional arterial infusion
  • protease inhibitors
  • severe acute pancreatitis
  • treatment

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

Cite this

Continuous Regional Arterial Infusion of Protease Inhibitors Has No Efficacy in the Treatment of Severe Acute Pancreatitis : A Retrospective Multicenter Cohort Study. / Horibe, Masayasu; Sasaki, Mitsuhito; Sanui, Masamitsu; Sugiyama, Daisuke; Iwasaki, Eisuke; Yamagishi, Yoshiyuki; Sawano, Hirotaka; Goto, Takashi; Ikeura, Tsukasa; Hamada, Tsuyoshi; Oda, Takuya; Yasuda, Hideto; Shinomiya, Wataru; Miyazaki, Dai; Hirose, Kaoru; Kitamura, Katsuya; Chiba, Nobutaka; Ozaki, Tetsu; Yamashita, Takahiro; Koinuma, Toshitaka; Oshima, Taku; Yamamoto, Tomonori; Hirota, Morihisa; Moriya, Takashi; Shirai, Kunihiro; Mayumi, Toshihiko; Kanai, Takanori.

In: Pancreas, Vol. 46, No. 4, 01.04.2017, p. 510-517.

Research output: Contribution to journalArticle

Horibe, M, Sasaki, M, Sanui, M, Sugiyama, D, Iwasaki, E, Yamagishi, Y, Sawano, H, Goto, T, Ikeura, T, Hamada, T, Oda, T, Yasuda, H, Shinomiya, W, Miyazaki, D, Hirose, K, Kitamura, K, Chiba, N, Ozaki, T, Yamashita, T, Koinuma, T, Oshima, T, Yamamoto, T, Hirota, M, Moriya, T, Shirai, K, Mayumi, T & Kanai, T 2017, 'Continuous Regional Arterial Infusion of Protease Inhibitors Has No Efficacy in the Treatment of Severe Acute Pancreatitis: A Retrospective Multicenter Cohort Study', Pancreas, vol. 46, no. 4, pp. 510-517. https://doi.org/10.1097/MPA.0000000000000775
Horibe, Masayasu ; Sasaki, Mitsuhito ; Sanui, Masamitsu ; Sugiyama, Daisuke ; Iwasaki, Eisuke ; Yamagishi, Yoshiyuki ; Sawano, Hirotaka ; Goto, Takashi ; Ikeura, Tsukasa ; Hamada, Tsuyoshi ; Oda, Takuya ; Yasuda, Hideto ; Shinomiya, Wataru ; Miyazaki, Dai ; Hirose, Kaoru ; Kitamura, Katsuya ; Chiba, Nobutaka ; Ozaki, Tetsu ; Yamashita, Takahiro ; Koinuma, Toshitaka ; Oshima, Taku ; Yamamoto, Tomonori ; Hirota, Morihisa ; Moriya, Takashi ; Shirai, Kunihiro ; Mayumi, Toshihiko ; Kanai, Takanori. / Continuous Regional Arterial Infusion of Protease Inhibitors Has No Efficacy in the Treatment of Severe Acute Pancreatitis : A Retrospective Multicenter Cohort Study. In: Pancreas. 2017 ; Vol. 46, No. 4. pp. 510-517.
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abstract = "Objective The aim of this study is to assess the effectiveness of continuous regional arterial infusion (CRAI) of protease inhibitors in patients with severe acute pancreatitis (SAP) including acute necrotizing pancreatitis. Methods This retrospective study was conducted among 44 institutions in Japan from 2009 to 2013. Patients 18 years or older diagnosed with SAP according to the criteria of the Japanese Ministry of Health, Labour and Welfare study group (2008) were consecutively enrolled. We evaluated the association between CRAI of protease inhibitors and mortality, incidence of infection, and the need for surgical intervention using multivariable logistic regression analysis. Results Of 1159 patients admitted, 1097 patients with all required data were included for analysis. Three hundred and seventy-four (34.1{\%}) patients underwent CRAI of protease inhibitors and 723 (65.9{\%}) did not. In multivariable analysis, CRAI of protease inhibitors was not associated with a reduction in mortality, infection rate, or need for surgical intervention (odds ratio [OR] 0.79, 95{\%} confidence interval [CI] 0.47-1.32, P = 0.36; OR 0.97, 95{\%} CI 0.61-1.54, P = 0.89; OR 0.76, 95{\%} CI 0.50-1.15, P = 0.19; respectively). Conclusions Continuous regional arterial infusion of protease inhibitors was not efficacious in the treatment of patients with SAP.",
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T1 - Continuous Regional Arterial Infusion of Protease Inhibitors Has No Efficacy in the Treatment of Severe Acute Pancreatitis

T2 - A Retrospective Multicenter Cohort Study

AU - Horibe, Masayasu

AU - Sasaki, Mitsuhito

AU - Sanui, Masamitsu

AU - Sugiyama, Daisuke

AU - Iwasaki, Eisuke

AU - Yamagishi, Yoshiyuki

AU - Sawano, Hirotaka

AU - Goto, Takashi

AU - Ikeura, Tsukasa

AU - Hamada, Tsuyoshi

AU - Oda, Takuya

AU - Yasuda, Hideto

AU - Shinomiya, Wataru

AU - Miyazaki, Dai

AU - Hirose, Kaoru

AU - Kitamura, Katsuya

AU - Chiba, Nobutaka

AU - Ozaki, Tetsu

AU - Yamashita, Takahiro

AU - Koinuma, Toshitaka

AU - Oshima, Taku

AU - Yamamoto, Tomonori

AU - Hirota, Morihisa

AU - Moriya, Takashi

AU - Shirai, Kunihiro

AU - Mayumi, Toshihiko

AU - Kanai, Takanori

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Objective The aim of this study is to assess the effectiveness of continuous regional arterial infusion (CRAI) of protease inhibitors in patients with severe acute pancreatitis (SAP) including acute necrotizing pancreatitis. Methods This retrospective study was conducted among 44 institutions in Japan from 2009 to 2013. Patients 18 years or older diagnosed with SAP according to the criteria of the Japanese Ministry of Health, Labour and Welfare study group (2008) were consecutively enrolled. We evaluated the association between CRAI of protease inhibitors and mortality, incidence of infection, and the need for surgical intervention using multivariable logistic regression analysis. Results Of 1159 patients admitted, 1097 patients with all required data were included for analysis. Three hundred and seventy-four (34.1%) patients underwent CRAI of protease inhibitors and 723 (65.9%) did not. In multivariable analysis, CRAI of protease inhibitors was not associated with a reduction in mortality, infection rate, or need for surgical intervention (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.47-1.32, P = 0.36; OR 0.97, 95% CI 0.61-1.54, P = 0.89; OR 0.76, 95% CI 0.50-1.15, P = 0.19; respectively). Conclusions Continuous regional arterial infusion of protease inhibitors was not efficacious in the treatment of patients with SAP.

AB - Objective The aim of this study is to assess the effectiveness of continuous regional arterial infusion (CRAI) of protease inhibitors in patients with severe acute pancreatitis (SAP) including acute necrotizing pancreatitis. Methods This retrospective study was conducted among 44 institutions in Japan from 2009 to 2013. Patients 18 years or older diagnosed with SAP according to the criteria of the Japanese Ministry of Health, Labour and Welfare study group (2008) were consecutively enrolled. We evaluated the association between CRAI of protease inhibitors and mortality, incidence of infection, and the need for surgical intervention using multivariable logistic regression analysis. Results Of 1159 patients admitted, 1097 patients with all required data were included for analysis. Three hundred and seventy-four (34.1%) patients underwent CRAI of protease inhibitors and 723 (65.9%) did not. In multivariable analysis, CRAI of protease inhibitors was not associated with a reduction in mortality, infection rate, or need for surgical intervention (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.47-1.32, P = 0.36; OR 0.97, 95% CI 0.61-1.54, P = 0.89; OR 0.76, 95% CI 0.50-1.15, P = 0.19; respectively). Conclusions Continuous regional arterial infusion of protease inhibitors was not efficacious in the treatment of patients with SAP.

KW - acute necrotizing pancreatitis

KW - continuous regional arterial infusion

KW - protease inhibitors

KW - severe acute pancreatitis

KW - treatment

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