Plasmapheresis may not Reduce Organ Failure among patients with hypertriglyceridemia associated pancreatitis
An Original Investigation on Gastroenterology and Hepatology published on June 28, 2023, in JAMA Network Open entitled "Early Plasmapheresis Among Patients With Hypertriglyceridemia–Associated Acute Pancreatitis" by lead author Cao et al. have mentioned that plasmapheresis does not confer any clinical benefit in managing hypertriglyceridemia-associated acute pancreatitis or HTG-AP and is associated with potential complications.
In this study, researchers found no association between plasmapheresis and the incidence and duration of organ failure. Plasmapheresis may not decrease triglyceride levels more efficiently than conventional medical therapy. These findings of the present study are comparable with those conducted by Chen et al. and Miyamoto et al.
It is already known that there is an increasing incidence of hypertriglyceridemia–associated acute pancreatitis (HTG-AP). Plasmapheresis is theoretically effective in removing triglyceride from plasma, but there needs to be more clarity on whether it has clinical benefits.
This multicenter, prospective cohort study enrolled patients from 28 sites across China. HTG-AP patients were admitted within 72 hours from the onset of the disease. The primary outcome was organ failure–free days to 14 days of enrolment, while other measures for organ failure, intensive care unit (ICU) admission, duration of ICU and hospital stays, the incidence of infected pancreatic necrosis, and 60-day mortality were the secondary outcomes.
The key results of this study are:
- Two hundred sixty-seven patients of mean age 37 years enrolled had a history of HTG-AP.
- Of these patients, 211 underwent conventional medical treatment, and 56 underwent plasmapheresis.
- No difference was detected concerning organ failure–free days between patients undergoing plasmapheresis or not.
- Researchers reported more ICU admission in the plasmapheresis group.
Study strength includes a large study size, reduced selection bias and valid comparison.
They said, "We found that early plasmapheresis is not associated with the incidence and duration of organ failure but with a greater need for ICU admission."
Further reading:
Cao L, Chen Y, Liu S, et al. Early Plasmapheresis Among Patients With Hypertriglyceridemia–Associated Acute Pancreatitis. JAMA Netw Open. 2023;6(6):e2320802. doi:10.1001/jamanetworkopen.2023.20802
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