Key result
In patients with severe hypertriglyceridemia-induced pancreatitis undergoing double filtration plasmapheresis, those with baseline triglycerides ≥33.9 mmol/L had a significantly greater median reduction in APACHE II scores compared to those with lower levels (9.5 vs 5.1, p<0.001).
Why the study?
The value of double filtration plasmapheresis (DFPP) in severe hypertriglyceridemia-induced pancreatitis (sHTGP) is controversial.
Does double filtration plasmapheresis improve clinical outcomes and reduce lipid profiles in patients with severe hypertriglyceridemia-induced pancreatitis?
Observational (n=50)
No
Does double filtration plasmapheresis improve clinical outcomes and reduce lipid profiles in patients with severe hypertriglyceridemia-induced pancreatitis?
Absolute Event Rate: 9.5% vs 5.1%
p-value: p=<0.001
Double filtration plasmapheresis rapidly reduces triglycerides and improves clinical severity scores in severe hypertriglyceridemia-induced pancreatitis, particularly benefiting those with very high baseline triglyceride levels.
May support DFPP consideration in sHTGP but should not change practice; leaves open need for RCTs on efficacy and costs.
Background The value of double filtration plasmapheresis (DFPP) in severe hypertriglyceridemia-induced pancreatitis (sHTGP) is controversial. This study aimed to investigate the efficacy of DFPP on clinical results in patients with sHTGP and the costs associated with the procedure. Methods Patients who underwent DFPP after admission between January 2016 and December 2021 were recruited. Data on lipid profile, clinical results, and costs were retrospectively collected and analyzed. Results Fifty sHTGP patients who received DFPP were enrolled. All of the lipid profile were significantly reduced and maintained a downward trend. The APACHE II score on admission was higher and the reduction after DFPP was more obvious (P < 0.05) in patients with higher triglyceride (TG) levels (≥ 33.9 mmol/L) than in patients with lower TG levels. More material fees were expended in the higher TG group due to more DFPP sessions (P < 0.05), but no significant differences existed in total hospital costs between the two groups. Conclusion DFPP could rapidly and effectively reduce TGs to a safe level. APACHE II score reduction was obvious in patients with TGs ≥ 33.9 mmol/L and was associated with lipid profile changes. DFPP may benefit sHTGP patients with a TG level higher than the current initiation threshold.
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Han et al. (2022) conducted an observational in Severe hypertriglyceridemia-induced pancreatitis (n=50). Baseline triglyceride level ≥ 33.9 mmol/L vs. Baseline triglyceride level < 33.9 mmol/L was evaluated on APACHE II score reduction after DFPP (p=<0.001). In patients with severe hypertriglyceridemia-induced pancreatitis undergoing double filtration plasmapheresis, those with baseline triglycerides ≥33.9 mmol/L had a significantly greater median reduction in APACHE II scores compared to those with lower levels (9.5 vs 5.1, p<0.001).
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