Protective effect of ulinastatin against negative inflammatory response and organ dysfunction in acute aortic dissection surgery: The PANDA trial

Cell Rep Med. 2025 Jan 21;6(1):101888. doi: 10.1016/j.xcrm.2024.101888.

Abstract

Ulinastatin is a protease-inhibiting drug with anti-inflammatory and other pharmacological properties. Little is known regarding its role following acute type A aortic dissection (ATAAD) surgery. We perform a randomized controlled trial to investigate the protective effect of ulinastatin against negative inflammatory response and organ dysfunction in ATAAD surgery (PANDA). The primary outcome of mean daily Sequential Organ Failure Assessment (SOFA) score from baseline to 7 days of surgery is 8.80 (SD, 4.11) in the ulinastatin group and 8.61 (SD, 4.47) in the control group (mean difference between groups was 0.04; 95% confidence interval [CI], -0.24 to 0.33; p = 0.765). Systemic inflammatory response syndrome (SIRS) within 7 days of surgery is lower in the ulinastatin group than in the control group (p < 0.001). Additional ulinastatin to standard treatment is likely to reduce SIRS rates instead of preventing organ dysfunction, highlighting the potential importance of the benefits of anti-inflammatory pharmacotherapeutics. The trial is registered on clinicaltrials.org (NCT04711889).

Keywords: mortality; systemic inflammatory response syndrome; type A aortic dissection; ulinastatin.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aortic Dissection* / surgery
  • Female
  • Glycoproteins* / pharmacology
  • Glycoproteins* / therapeutic use
  • Humans
  • Inflammation / drug therapy
  • Male
  • Middle Aged
  • Multiple Organ Failure* / prevention & control
  • Systemic Inflammatory Response Syndrome* / drug therapy
  • Systemic Inflammatory Response Syndrome* / prevention & control

Substances

  • urinastatin
  • Glycoproteins

Associated data

  • ClinicalTrials.gov/NCT04711889