Activated Protein C in Severe Acute Pancreatitis
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Purpose
Activated protein C (APC)has been shown to reduce mortality in severe sepsis(Bernard et al. 2001b). The clinical picture of severe acute pancreatitis (AP) is similar to that of sepsis. The investigators conducted a randomised double-blinded placebo-controlled pilot study in AP patients (16+16) with the same dose of APC that has been proven to be efficacious and safe in septic patients.
The aim of the study is to investigate whether the APC replacement therapy diminishes the occurrence and severity of organ dysfunction in patients with severe AP. The effect of APC on inflammatory and hemostatic parameters is also assessed.
| Condition | Intervention | Phase |
|---|---|---|
|
Acute Pancreatitis |
Drug: Activated protein C |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | APCAP - Activated Protein C in Severe Acute Pancreatitis: A Double-blind Randomized Human Pilot Trial |
- The primary safety endpoint was the number of bleedings, and the primary efficacy endpoint was the change in SOFA between the start of the drug (day 0) and day 5. [ Time Frame: 0-60 days ] [ Designated as safety issue: Yes ]
- Organ failure free days alive [ Time Frame: 0-60 days ] [ Designated as safety issue: Yes ]
| Enrollment: | 32 |
| Study Start Date: | June 2003 |
| Study Completion Date: | September 2007 |
| Primary Completion Date: | September 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Activated protein C |
Drug: Activated protein C
24 micrograms/kg/hour intravenously for 96 hours
|
Detailed Description:
The study started in 2003 and was finished in 2007. The study was registered in The Helsinki University Central Hospital study register in 2003.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Admitted to hospital within 72 h of the onset of pain.
- Plasma amylase concentration more than three times the upper limit of the normal range and/or CT findings compatible with AP.
- Organ failure and <48h of the onset of the first organ failure
Exclusion Criteria:
- HIV / B- or C hepatitis infection
- Pregnancy or breast feeding
- Active bleeding
- Increased risk of bleeding (thrombocytes <30x10E9/L or INR>3.0
- Gastrointestinal bleeding within 6 weeks or intracranial stroke within 3 months before the study
- Intravenous contrast extravasation or other signs (fresh hematoma) suggesting active hemorrhage within the pancreas or in the peripancreatic area on admission CT scan
- Use of antithrombin III within 12 h
- Use of acetylsalicylic acid or glycoprotein IIB/IA antagonist within 7 days / Thrombolytic therapy within 3 days
- Surgery requiring general or spinal anaesthesia within 12 h
- Previous pancreatic surgery
- Application of an epidural catheter within 48 h
Contacts and Locations| Finland | |
| Helsinki University Central Hospital | |
| Helsinki, Finland, 00290 | |
| Principal Investigator: | Ville Pettilä, MD, PhD | Helsinki University Central Hospital |
More Information
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Kemppainen Esko / M.D. PhD, Helsinki University Central Hospital |
| ClinicalTrials.gov Identifier: | NCT01017107 History of Changes |
| Other Study ID Numbers: | HUS 210284 |
| Study First Received: | November 19, 2009 |
| Last Updated: | October 13, 2010 |
| Health Authority: | Finland: Finnish Medicines Agency |
Keywords provided by Helsinki University Central Hospital:
|
acute pancreatitis treatment organ failure activated protein c |
Additional relevant MeSH terms:
|
Pancreatitis Pancreatic Diseases Digestive System Diseases Protein C Anticoagulants Hematologic Agents |
Therapeutic Uses Pharmacologic Actions Fibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Cardiovascular Agents |
ClinicalTrials.gov processed this record on May 16, 2013