Immune-Enhancing Treatment among Acute Necrotizing Pancreatitis Patients with Metabolic Abnormalities: A <i>Post Hoc</i> Analysis of a Randomized Clinical Trial.
Huang. Xiaofei X; Mao. Wenjian W; Hu. Xingxing X; Qin. Fengxia F; Zhao. Hui H; Zhang. Aiping A; Wang. Xinyu X; Stoppe. Christian C; Zhou. Dandan D; Ke. Lu L; Ni. Haibin H
Key Findings
- Thymosin‑alpha‑1 reduced 90‑day infected pancreatic necrosis in patients with hyperglycemia (HR 0.80, p=0.03).
- No significant benefit was seen in patients without hyperglycemia or with only high triglycerides.
- Results held up after adjusting for bias with multiple propensity‑score methods.
Practical Outcomes
- For biohackers, the take‑away is that thymosin‑alpha‑1 might be useful as an acute, medically‑supervised therapy for infection risk in severe pancreatitis when blood sugar is high, but it isn’t a general longevity or performance supplement. It requires clinical dosing and monitoring, and there’s no evidence it helps healthy people or those without pancreatic disease.
Summary
In a study of people with severe pancreas inflammation, giving the immune‑boosting peptide thymosin‑alpha‑1 lowered the chance of getting a serious infection, but only in those who also had high blood sugar. It didn’t help patients without high blood sugar, and the research was done in a hospital setting, not as a routine supplement.
Abstract
Metabolic syndrome is common in patients with acute pancreatitis and its components have been reported to be associated with infectious complications. In this <i>post hoc</i> analysis, we aimed to evaluate whether metabolic abnormalities impact the effect of immune-enhancing thymosin alpha-1 (Tα1) therapy in acute necrotizing pancreatitis (ANP) patients. All data were obtained from the database for a multicenter randomized clinical trial that evaluated the efficacy of Tα1 in ANP patients. Patients who discontinued the Tα1 treatment prematurely were excluded. The primary outcome was 90-day infected pancreatic necrosis (IPN) after randomization. Three <i>post hoc</i> subgroups were defined based on the presence of hyperglycemia, hypertriglyceridemia, or both at the time of randomization. In each subgroup, the correlation between Tα1 and 90-day IPN was assessed using the Cox proportional-hazards regression model. Multivariable propensity-score methods were used to control potential bias. Overall, 502 participants were included in this <i>post hoc</i> analysis (248 received Tα1 treatment and 254 received matching placebo treatment). Among them, 271 (54.0%) had hyperglycemia, 371 (73.9%) had hypertriglyceridemia and 229 (45.6%) had both. Tα1 therapy was associated with reduced incidence of IPN among patients with hyperglycemia (18.8% vs 29.7%: hazard ratio, 0.80; 95% confidence interval, 0.37 to 0.97; p=0.03), but not in the other subgroups. Additional multivariate regression models using three propensity-score methods yielded similar results. Among ANP patients with hyperglycemia, immune-enhancing Tα1 treatment was associated with a reduced risk of IPN (ClinicalTrials.gov, Registry number: NCT02473406).
Study Information
pubmed
2024
2024-02-15T00:00:00.000Z
10.5009/gnl230326