Effectiveness of ulinastatin in critical care patients in real world: a retrospective multi-center study.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY Expert Review of Clinical Pharmacology Pub Date : 2024-10-03 DOI:10.1080/17512433.2024.2402433

Deduo Xu, Yi Shan, Qinghua Liu, Pei Liang, Xin Hao, Jinyuan Zhang, Ze Yu, Wenfang Li, Fei Gao, Xia Tao, Qin Gu, Yabin Ma, Wansheng Chen

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Abstract

Objectives: Ulinastatin has been applied in various diseases associated with inflammation, but its effectiveness lacks real-world evidence. We aimed to evaluate the effectiveness of ulinastatin based on a real-world database in the intensive care unit (ICU) patients.

Methods: This was a retrospective cohort study. ICU patient data from multi-centers in China were collected. Propensity score matching (PSM) was applied. The effectiveness of ulinastatin was evaluated by mortality, length of stay in the ICU and mechanical ventilation duration. Kaplan-Meier method was used to estimate the hazard ratio and plot the survival curve.

Results: A total of 2036 patients were analyzed after PSM. Mortality was significantly lower in the ulinastatin group than in the non-ulinastatin group (hazard ratio for death: 0.77; 95% confidence interval: 0.62-0.96; p = 0.018). Ulinastatin significantly reduced mortality at 28 days (10.0% vs. 13.6%), 60 days (13.9% vs. 18.2%) and 90 days (14.7% vs. 18.5%), length of stay in the ICU (median 8.0 d vs. 13.0 d), and mechanical ventilation duration (median 24.0 h vs. 25.0 h; p < 0.05).

Conclusions: Ulinastatin was beneficial for patients in the ICU, mainly by reducing mortality, length of ICU stay, and mechanical ventilation duration. This study provides evidence of the clinical effectiveness of ulinastatin.

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乌利那他汀在重症监护患者中的实际疗效：一项多中心回顾性研究。

研究目的乌利那他汀已被应用于多种与炎症相关的疾病，但其有效性缺乏真实世界的证据。我们的目的是根据重症监护室（ICU）患者的实际数据库评估乌利那他汀的疗效：这是一项回顾性队列研究。方法：这是一项回顾性队列研究，收集了来自中国多个中心的 ICU 患者数据。采用倾向得分匹配法（PSM）。通过死亡率、ICU住院时间和机械通气时间评估乌利那他汀的疗效。采用卡普兰-梅耶法估算危险比并绘制生存曲线：结果：共分析了 2036 名 PSM 患者。乌利那他汀组的死亡率明显低于非乌利那他汀组（死亡危险比：0.77；95% 置信区间：0.62-0.96；P = 0.018）。乌利那他汀能明显降低28天（10.0% vs. 13.6%）、60天（13.9% vs. 18.2%）和90天（14.7% vs. 18.5%）的死亡率、重症监护室住院时间（中位数8.0天 vs. 13.0天）和机械通气时间（中位数24.0小时 vs. 25.0小时；P 结论：乌利那他汀能明显降低重症监护室住院时间（中位数8.0天 vs. 13.0天）和机械通气时间（中位数24.0小时 vs. 25.0小时）：乌利那他汀对重症监护病房的患者有益，主要是降低了死亡率、缩短了重症监护病房的住院时间和机械通气时间。这项研究为乌利那他汀的临床疗效提供了证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-

CiteScore

7.30

自引率

2.30%

发文量

127

期刊介绍： Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.