Adjunctive gabexate mesylate with octreotide and clinical outcomes in older adults with acute pancreatitis: a retrospective study
- 1Department of Emergency, Qinhuangdao First Hospital
- 2Department of Emergency, Qinhuangdao Third Hospital
- 3Department of Emergency, Handan Hospital of Integrated Traditional Chinese and Western Medicine
Abstract
Background: Acute pancreatitis (AP) in older adults is associated with higher risks of systemic inflammatory response, organ dysfunction, and prolonged clinical recovery. Pharmacologic interventions targeting early protease activation and exocrine pancreatic secretion may have therapeutic value in this population; however, evidence in elderly patients remains limited.
Methods: This retrospective study included 220 adults aged ≥60 years hospitalized with AP between July 2021 and July 2025. Among them, 108 received octreotide plus gabexate mesylate and 112 received octreotide monotherapy. Primary outcomes were times to abdominal pain relief, pancreatic enzyme normalization, and gastrointestinal recovery. Multiple linear and multivariable logistic regression models were used to adjust for prespecified demographic and clinical covariates.
Results: Combination therapy was associated with shorter times to abdominal pain relief (adjusted mean difference −0.95 days; 95% confidence interval [CI] −1.28 to −0.62), pancreatic enzyme normalization (−1.28 days; 95% CI, −1.67 to −0.89), gastrointestinal recovery (−0.86 days; 95% CI −1.25 to −0.47), and hospital discharge (−1.62 days; 95% CI, −2.47 to −0.77; all P ≤ 0.001). It was also associated with higher odds of radiological improvement among re-imaged patients (adjusted odds ratio [OR], 1.82; 95% CI, 1.16–2.86) and lower odds of new-onset or persistent systemic inflammatory response syndrome (adjusted OR, 0.61; 95% CI, 0.38–0.98) and infectious complications (adjusted OR, 0.54; 95% CI, 0.29–0.99). Drug-related adverse events, composite organ dysfunction, mortality, and readmission did not differ significantly. No treatment-by-severity interaction was identified.
Conclusion: Adjunctive gabexate mesylate was associated with modestly faster short-term recovery in older adults with acute pancreatitis, without a significant increase in drug-related adverse events. Its effects on organ dysfunction and mortality remain uncertain and require confirmation in prospective randomized studies.
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BibTeX
@article{zhu2026adjunctive,
title = {{Adjunctive gabexate mesylate with octreotide and clinical outcomes in older adults with acute pancreatitis: a retrospective study}},
author = {Chao Zhu and Hua Feng and Liang Xu and Chun-Hong Li and Xiao-Hui Liu},
journal = {Frontiers in Pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1755737},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1755737/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Adjunctive gabexate mesylate with octreotide and clinical outcomes in older adults with acute pancreatitis: a retrospective study
AU - Chao Zhu
AU - Hua Feng
AU - Liang Xu
AU - Chun-Hong Li
AU - Xiao-Hui Liu
PY - 2026
DA - 2026/10/14
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1755737
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1755737/full
AB - Background: Acute pancreatitis (AP) in older adults is associated with higher risks of systemic inflammatory response, organ dysfunction, and prolonged clinical recovery. Pharmacologic interventions targeting early protease activation and exocrine pancreatic secretion may have therapeutic value in this population; however, evidence in elderly patients remains limited. Methods: This retrospective study included 220 adults aged ≥60 years hospitalized with AP between July 2021 and July 2025. Among them, 108 received octreotide plus gabexate mesylate and 112 received octreotide monotherapy. Primary outcomes were times to abdominal pain relief, pancreatic enzyme normalization, and gastrointestinal recovery. Multiple linear and multivariable logistic regression models were used to adjust for prespecified demographic and clinical covariates. Results: Combination therapy was associated with shorter times to abdominal pain relief (adjusted mean difference −0.95 days; 95% confidence interval [CI] −1.28 to −0.62), pancreatic enzyme normalization (−1.28 days; 95% CI, −1.67 to −0.89), gastrointestinal recovery (−0.86 days; 95% CI −1.25 to −0.47), and hospital discharge (−1.62 days; 95% CI, −2.47 to −0.77; all P ≤ 0.001). It was also associated with higher odds of radiological improvement among re-imaged patients (adjusted odds ratio [OR], 1.82; 95% CI, 1.16–2.86) and lower odds of new-onset or persistent systemic inflammatory response syndrome (adjusted OR, 0.61; 95% CI, 0.38–0.98) and infectious complications (adjusted OR, 0.54; 95% CI, 0.29–0.99). Drug-related adverse events, composite organ dysfunction, mortality, and readmission did not differ significantly. No treatment-by-severity interaction was identified. Conclusion: Adjunctive gabexate mesylate was associated with modestly faster short-term recovery in older adults with acute pancreatitis, without a significant increase in drug-related adverse events. Its effects on organ dysfunction and mortality remain uncertain and require confirmation in prospective randomized studies.
SN - 1663-9812
ER -