Evaluation of Mesna Co-administration in the Management of Acute Pancreatitis: A Pilot Randomized Clinical Trial

Abstract

Background: The use of antioxidants has been shown to mitigate the symptoms of acute pancreatitis (AP) and improve associated biomarkers. Objectives: In light of the antioxidant properties of mesna, this pilot study was undertaken to determine whether the addition of mesna to standard treatment for AP offers superior outcomes compared with standard treatment alone. Methods: In a randomized open-label pilot trial, patients diagnosed with AP were enrolled in the study. Intravenous mesna at a dose of 400 mg/day was administered for 7 days. Clinical indicators, including the Harmless Acute Pancreatitis Score (HAPS), amylase, lipase, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and malondialdehyde (MDA), were measured at baseline and after the 7-day treatment period. Results: Although MDA levels significantly decreased in the group receiving mesna combined with standard therapy compared with the group receiving standard therapy alone after 7 days (P = 0.01), no significant differences were observed between the 2 groups in terms of HAPS, amylase, lipase, CRP, or ESR. Conclusions: These findings suggest that the addition of mesna at a daily dose of 400 mg did not influence the overall outcome of AP after 7 days. Further large-scale studies with varying doses and durations of mesna administration are recommended.