Efficacy and safety of pharmacological and procedural interventions in the management of hypertriglyceridemia-induced acute pancreatitis: a systematic review.

The optimal management strategy for hypertriglyceridemia-induced acute pancreatitis (HTGAP) remains uncertain, despite widespread use of treatment modalities including insulin therapy, heparin infusion, and plasmapheresis. Current evidence supporting the effectiveness and safety of these interventions is limited, leading to ongoing debate about their role in HTGAP treatment. This study aimed to synthesize the available evidence on the efficacy and safety of various management strategies for HTGAP. Following PRISMA guidelines for systematic reviews, we conducted a comprehensive search of the following electronic databases from their inception until October 2024: PubMed, EMBASE, Science Direct, Cochrane library, ProQuest, and Scopus. Studies were included if they were human-based quantitative study design involving a comparison group. The quality assessment tools applied were Jadad scale and CASP tool. Fourteen eligible studies were included in this review were the majority of which were cohort studies (n = 12) with (n = 10) followed a retrospective observational study design. Plasmapheresis significantly reduced triglyceride levels in six studies, while hemofiltration showed similar effectiveness in two studies. Plasmapheresis also demonstrated a statistically significant reduction in length of hospital stay across four studies. The majority of the studies (n = 12) reported no statistically significant effect on mortality. Safety reporting was notably limited, with only four studies documenting treatment-related adverse events. Plasmapheresis and hemofiltration show potential benefits in HTGAP management, but definitive conclusions regarding efficacy and safety remain challenging due to heterogeneous data and limited high-quality studies. Further robust research is needed to establish a well-informed consensus on optimal treatment strategies.