Anti-Adhesion Agent May Reduce Post-Surgical Infertility

A new study has found that a 4% Icodextrin solution was more effective in reducing the incidence of post-operative adhesions in patients undergoing gynecological laparoscopic adhesiolysis than lactated Ringer's solution (LRS).

Researchers at University of Sheffield (United Kingdom) and other institutions conducted a randomized, double-blinded trial that involved 402 patients who underwent gynecological laparoscopic surgery involving adhesiolysis at 16 sites in the United States. Two hundred and three patients were administered Adept adhesion reduction solution [4% Icodextrin Solution] during surgery and 199 patients were administered LRS. The Patients' primary diagnoses included pelvic pain, infertility, endometriosis, and known adhesions. A second follow-up laparoscopy was scheduled four to eight weeks later.

The results showed that among patients in the Adept group, more than 45% achieved clinical success--defined as the greater of a reduction in adhesions of at least three or 30% of sites lysed between the first and second laparoscopies--during the second physician observation compared to 35.6% in the LRS group. Among infertility patients, 52.9% of patients in the Adept group had a positive reduction in American Fertility Score (AFS), the standardized method to score and classify adhesions to the ovaries or fallopian tubes that may affect fertility, compared to 30.4% in the LRS group. The study was published in the November 2007 issue of Fertility and Sterility.

Adept adhesion reduction solution, a product of Vectura (Chippenham, UK), and Baxter International (Deerfield, Il, USA), is indicated for use intraperitoneally for the reduction of post-surgical adhesions in patients undergoing gynecological laparoscopic adhesiolysis. Adept is contraindicated in patients with known or suspected allergy to cornstarch based on polymers, such as icodextrin, with maltose or isomaltose intolerance, or with glycogen storage disease.

"Adhesions can take several days to form following surgery,” said Ron Lloyd, vice president of Baxter's biotherapeutics and regenerative medicine business. "Adept forms a fluid reservoir in the peritoneal cavity, that resides there during the critical period of adhesion formation, separating and minimizing contact between organs.”


Related Links:
University of Sheffield
Vectura
Baxter International