Department of Pharmacy, Changhai Hospital, The Second Military Medical University, Shanghai, China.
Department of Information, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.
Ann Palliat Med. 2021 Feb;10(2):1325-1335. doi: 10.21037/apm-19-363. Epub 2020 Oct 9.
Although somatostatin and its analogs and trypsin inhibitors (TSI) are widely recommended for acute pancreatitis (AP), there is a lack of high-quality multicenter trials that validate these drug classes. We aimed to examine the current usage status of somatostatin and its analogs and TSI in Chinese adult AP patients.
We conducted a retrospective study which collected information for adult patients who were diagnosed with AP from January 1, 2015 to June 30, 2017 at 192 hospitals in China. Subsequently, we conducted a statistical analysis of the baseline information of patients, and revealed the usage of somatostatin, octreotide, ulinastatin, and gabexate. Thereafter, we stratified AP by severity and analyzed the current status of treatment.
A total of 34,654 patients were included in this study. Mean age of patients was 49.9 years and 63% were males. Fifty-five percent of mild AP patients opted to receive octreotide, while 53.66% and 64.61% of moderate AP and severe AP patients respectively opted to receive somatostatin. At treatment initiation, somatostatin was mainly prescribed for mild and moderate AP patients, which were 723 and 894 daily defined doses (i.e., defined dose per day for a drug used by every 1,000 patients). Ulinastatin was mainly prescribed for severe AP patients, with a prescription volume of 1,230 daily defined doses. The consumption of ulinastatin in later stages of severe AP treatment was significantly greater than other drugs.
Somatostatin analogs and TSI are widely used as therapeutic drugs for AP treatment in China, with usage beginning at the early stages of the disease and lasting on average for 1 week. Of these drugs, somatostatin and octreotide were identified as the most commonly-used drugs, while ulinastatin was found to be widely used at the late stages of severe AP.
尽管生长抑素及其类似物和胰蛋白酶抑制剂(TSI)被广泛推荐用于治疗急性胰腺炎(AP),但缺乏验证这些药物类别的高质量多中心试验。我们旨在研究生长抑素及其类似物和 TSI 在我国成年 AP 患者中的使用现状。
我们进行了一项回顾性研究,收集了 2015 年 1 月 1 日至 2017 年 6 月 30 日期间在中国 192 家医院诊断为 AP 的成年患者的信息。随后,我们对患者的基线信息进行了统计分析,并揭示了生长抑素、奥曲肽、乌司他丁和加贝酯的使用情况。此后,我们根据严重程度对 AP 进行分层,并分析了治疗现状。
本研究共纳入 34654 例患者。患者平均年龄为 49.9 岁,男性占 63%。55%的轻症 AP 患者选择使用奥曲肽,53.66%和 64.61%的中症和重症 AP 患者分别选择使用生长抑素。在治疗开始时,生长抑素主要用于轻中和中度 AP 患者,分别为 723 和 894 日治疗剂量(即每 1000 例患者使用的药物的日定义剂量)。乌司他丁主要用于重症 AP 患者,处方量为 1230 日治疗剂量。在重症 AP 治疗后期,乌司他丁的用量明显大于其他药物。
生长抑素类似物和 TSI 在中国被广泛用作 AP 治疗的治疗药物,从疾病早期开始使用,平均持续约 1 周。在这些药物中,生长抑素和奥曲肽被认为是最常用的药物,而乌司他丁在重症 AP 的晚期被广泛使用。