Literature DB >> 15999923

Gabexate mesilate and acute pancreatitis: an experience of evidence based drug information for improving rational drug use.

Roberto Banfi1, Giovanna Borselli, Silvia Cappelletti, Leonardo Mari, Massimo Aiazzi, Vittorio Taddei.   

Abstract

INTRODUCTION: Gabexate mesylate is a drug marketed only in Italy and Japan and it is considered an essential drug in the treatment of acute pancreatitis. A periodic revision and evaluation of drug utilization in our hospital demonstrated that the dosages and indications of Gabexate mesilate (GM) did not follow those settled by the National Health System and by our Hospital Formulary. We therefore promoted and conducted a program of drug information and meetings with the physicians in order to improve the correct utilisation of GM and identify potential problems.
METHODS: GM prescriptions in 1999 were analysed for indications and dosages. Scheduled meetings with the medical staff were successively started in order to debate current therapies and treatments of acute pancreatitis using the criteria of evidence-based medicine (EBM). Follow-up was done in 2000, 2001 and 2002 to evaluate the efficacy of our intervention.
RESULTS: The hospital board and 20 physicians were involved in this program of evidence-based drug information. The follow-up and the monitoring of GM prescriptions showed a reduction in the utilisation of GM in the subsequent period.
CONCLUSIONS: GM is one of the most expensive drugs in our hospital, but its benefits are not very evident. Moreover, the international guidelines and literature ascribe to GM only a marginal role in the treatment of acute pancreatitis. Evidence-based medicine strengthens clinical experience with the evidence from the literature and underlines that essential drugs are used worldwide.

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Year:  2005        PMID: 15999923     DOI: 10.1007/s11096-004-5692-4

Source DB:  PubMed          Journal:  Pharm World Sci        ISSN: 0928-1231


  14 in total

1.  United Kingdom guidelines for the management of acute pancreatitis. British Society of Gastroenterology.

Authors: 
Journal:  Gut       Date:  1998-06       Impact factor: 23.059

2.  Meta-analysis of somatostatin, octreotide and gabexate mesilate in the therapy of acute pancreatitis.

Authors:  A Andriulli; G Leandro; R Clemente; V Festa; N Caruso; V Annese; G Lezzi; E Lichino; F Bruno; F Perri
Journal:  Aliment Pharmacol Ther       Date:  1998-03       Impact factor: 8.171

3.  A single-centre double-blind trial of Trasylol therapy in primary acute pancreatitis.

Authors:  C W Imrie; I S Benjamin; J C Ferguson; A J McKay; I Mackenzie; J O'Neill; L H Blumgart
Journal:  Br J Surg       Date:  1978-05       Impact factor: 6.939

Review 4.  The management of severe acute necrotising pancreatitis: an evidence-based review of the literature.

Authors:  D L Wyncoll
Journal:  Intensive Care Med       Date:  1999-02       Impact factor: 17.440

5.  A randomized, controlled trial of octreotide in the management of patients with acute pancreatitis.

Authors:  C McKay; J Baxter; C Imrie
Journal:  Int J Pancreatol       Date:  1997-02

6.  Randomized controlled multicentre study of the prevention of complications by octreotide in patients undergoing surgery for chronic pancreatitis.

Authors:  H Friess; H G Beger; U Sulkowski; H Becker; B Hofbauer; H J Dennler; M W Büchler
Journal:  Br J Surg       Date:  1995-09       Impact factor: 6.939

7.  Gabexate mesilate vs aprotinin in human acute pancreatitis (GA.ME.P.A.). A prospective, randomized, double-blind multicenter study.

Authors:  P Pederzoli; G Cavallini; M Falconi; C Bassi
Journal:  Int J Pancreatol       Date:  1993-10

8.  Multicenter double-blind trial of gabexate mesylate (FOY) in unselected patients with acute pancreatitis.

Authors:  R Valderrama; M Pérez-Mateo; S Navarro; N Vázquez; L Sanjosé; M J Adrián; J Estruch
Journal:  Digestion       Date:  1992       Impact factor: 3.216

9.  Controlled trial of protease inhibitor gabexelate mesilate (FOY) in the treatment of acute pancreatitis.

Authors:  C Y Yang; C S Chang-Chien; Y F Liaw
Journal:  Pancreas       Date:  1987       Impact factor: 3.327

10.  Preliminary report of a prospective randomized study of octreotide in the treatment of severe acute pancreatitis.

Authors:  H Paran; D Neufeld; A Mayo; I Shwartz; P Singer; O Kaplan; Y Skornik; J Klausner; U Freund
Journal:  J Am Coll Surg       Date:  1995-08       Impact factor: 6.113

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