Cj. Mckay et al., PROSPECTIVE PLACEBO-CONTROLLED RANDOMIZED TRIAL OF LEXIPAFANT IN PREDICTED SEVERE ACUTE-PANCREATITIS, British Journal of Surgery, 84(9), 1997, pp. 1239-1243
Background Many patients with severe acute pancreatitis develop organ
system failure during the first few days of illness, and this accounts
for the majority of early deaths. No specific therapy is available an
d treatment remains supportive. Methods In a randomized controlled tri
al conducted in 11 hospitals in the West of Scotland, 50 patients with
predicted severe acute pancreatitis were selected from 188 screened o
ver a 14-month period. Patients received placebo or lexipafant, a pote
nt platelet-activating factor antagonist, by continuous intravenous in
fusion at a dose of 100 mg/day for up to 7 days. Early systemic compli
cations were assessed by the measurement of organ failure scores. Resu
lts There was a significantly greater fall in organ failure score in t
he treatment group during the 7 days of study (mean and median changes
in organ failure score were 0.17 and 0 in the placebo group versus -1
.42 and -1 in the treatment group; P = 0.003, Wilcoxon rank sum test),
associated with trends towards a reduction in mortality and a reduced
incidence of systemic complications. Conclusion These results suggest
that lexipafant may be a useful adjunct to full supportive care in th
e early management of patients with severe acute pancreatitis.