Efficacy and Role of Ulinastatin in the Management of Acute Pancreatitis: A Systematic Review

Abstract

Background: Acute pancreatitis (AP) is an inflammation of the pancreas that can vary from a mild, self-resolving condition to severe necrotizing pancreatitis accompanied by multi-organ failure. The disease progression is primarily driven by an excessive inflammatory response. Methods: A systematic review was performed to assess the efficacy and therapeutic role of Ulinastatin in managing acute pancreatitis, based on existing clinical and experimental evidence. Results: Out of 59 studies screened, 4 were included in the analysis. The mortality rate was higher in the placebo group, while the Ulinastatin group showed a significantly reduced duration of hospital stay. Patients receiving 400,000 and 600,000 units had reduced hospital stays. Relative risk for mortality was lower in higher Ulinastatin dosage groups compared to the 200,000 IU reference: 0.60 for 400,000 IU and 0.36 for 600,000 IU, indicating a significant mortality reduction with increased dosage. Ulinastatin treatment led to more significant improvements in laboratory findings and symptoms. Conclusion: Ulinastatin shows considerable promise as an adjunct treatment for acute pancreatitis by regulating inflammatory pathways and enhancing clinical outcomes. It may play a key role in preventing organ failure and lowering mortality in cases of severe acute pancreatitis.