![]() ![]() The Lexipafant study was a randomized, multicenter, double-blind, placebo-controlled, phase III trial to determine if an infusion of Lexipafant given within 48 hours of the onset of symptoms of pancreatitis could reduce all-cause mortality within 28 days. We then compared its prognostic reliability with the established systems for predicting acute pancreatitis severity. To accomplish this, we analyzed data from the recent Lexipafant 21–27 pancreatitis trial to develop a system that could be used at admission. We sought to develop a simple model for predicting acute pancreatitis severity. Consequently, several simple, clinically useful predictors of early severity have been proposed, such as trypsinogen activation peptide (TAP), 16,17 C-reactive protein (CRP), 18–20 and interleukin-6 (IL-6), 19 but lack of specificity has limited their widespread clinical application. The revised Acute Physiologic and Chronic Health Evaluation (APACHE II) 11,12 scoring system allows patients to be stratified at admission, 13–15 but its unwieldiness (weighted scoring of 3 sets of variables) continues to limit its use. 9,10 Known as the Ranson and Glasgow systems, they have allowed patients to be stratified according to disease severity and resources to be focused on appropriate treatment regimens however, both systems use a prognostic score that is based on data collected over 24 to 48 hours, effectively resulting in what many consider a missed opportunity for intervention. The perpetual failure of clinical assessment to accurately predict pancreatitis severity 5,6 led to the development of prognostic scoring systems based on objective clinical and laboratory data by Ranson et al 7,8 and Imrie et al. 1–4 Identifying patients who will require aggressive resuscitation and intensive care measures therefore remains imperative. Although advances in understanding the pathophysiology of acute pancreatitis and treating its complications have improved patient outcomes, the mortality rate for severe pancreatitis remains 8% to 15%.
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