Key result
Therapeutic plasma exchange increased the odds of reducing triglycerides to <500 mg/dL within 48 hours compared to conservative treatment (OR 3.03; 95% CI 1.28-7.19; P=0.012).
Why the study?
The study was conducted to investigate the effect of therapeutic plasma exchange on lowering triglyceride levels in patients with hypertriglyceridemic pancreatitis.
Does therapeutic plasma exchange improve triglyceride reduction to less than 500 mg/dL within 48 hours in patients with hypertriglyceridemic pancreatitis?
Cohort
Does therapeutic plasma exchange improve triglyceride reduction to less than 500 mg/dL within 48 hours in patients with hypertriglyceridemic pancreatitis?
Odds Ratio: 3.03 (95% CI 1.28–7.19)
p-value: p=.012
Therapeutic plasma exchange provides a more rapid short-term reduction in triglycerides in hypertriglyceridemic pancreatitis compared to conservative treatment, but does not offer an advantage in triglyceride levels after 72 hours or in clinical outcomes.
TPE may hasten TG reduction in HLAP; hypothesis-generating and requires RCTs before practice change.
OBJECTIVE: To investigate the effect of therapeutic plasma exchange (TPE) on lowering triglyceride (TG) levels in patients with hypertriglyceridemic pancreatitis (HLAP). METHODS: The TG-lowering in patients with HLAP was compared between the TPE group and conservative treatment group (non-TPE). The primary outcome was TG reduction to less than 500 mg/dL within 48 hours. RESULTS: The primary outcome was significantly correlated with TPE (univariate analysis odds ratio [OR] 2.74; 95% confidence interval [CI] 1.30-5.79, P = .008; multivariate analysis OR 3.03; 95% CI 1.28-7.19, P = .012). At 24 and 48 hours, conservative treatment resulted in a 48.24% and 70.44% reduction in TG, while TPE resulted in a 70.91% and 76.39% reduction in TG, respectively. A more rapid decrease of in TGs in a short period was clearly associated with TPE (P < .001 for interaction). After 72 hours, the TGs decreased by approximately 77% in both groups, with no significant difference (P = .563). There was no difference between groups in clinical outcomes over the acute time period or over the longer term. CONCLUSIONS: In patients with HLAP, TPE resulted in a short-term and rapid reduction in plasma TG concentrations, with no significant advantage over non-TPE after 72 hours.
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Chen et al. (2021) conducted a cohort in Hypertriglyceridemic pancreatitis (HLAP). Therapeutic plasma exchange (TPE) vs. Conservative treatment (non-TPE) was evaluated on Triglyceride reduction to less than 500 mg/dL within 48 hours (OR 3.03, 95% CI 1.28-7.19, p=.012). Therapeutic plasma exchange increased the odds of reducing triglycerides to <500 mg/dL within 48 hours compared to conservative treatment (OR 3.03; 95% CI 1.28-7.19; P=0.012).
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