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DewDiligence

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DewDiligence

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Re: None

Friday, 09/22/2006 3:02:16 PM

Friday, September 22, 2006 3:02:16 PM

Post# of 19309
This is a new meta-analysis of antithrombin in sepsis.
What’s surprising and encouraging is that, in the three
studies included in the analysis, AT treatment had a
pronounced, positive effect on mortality even though
the meta-analysis did not exclude cases where heparin
was co-administered.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&l...

>>
A Systematic Review of Antithrombin Concentrate Use in Patients with Disseminated Intravascular Coagulation of Severe Sepsis

Blood Coagul Fibrinolysis. 2006 Oct;17(7):521-6.

Wiedermann CJ, Kaneider NC.

Division of Internal Medicine II, Department of Medicine, Central Hospital of Bolzano, Bolzano/Bozen, Italy; Division of General Internal Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria.

The objective was to estimate the effect of antithrombin therapy on mortality in disseminated intravascular coagulation (DIC) of severe sepsis and septic shock. Randomized clinical trials (RCT) on patients with DIC and severe sepsis or septic shock assigned to intravenous antithrombin or placebo were searched.

Eligible studies reported death as the outcome measure. Of 35 randomized controlled trials, 32 trials were excluded because patients were not randomized to antithrombin versus placebo, or no separate data on patients with DIC were given. In three trials, 364 patients with severe sepsis or septic shock and DIC were randomized. The disease severity, definition of DIC, dose and duration of treatment varied among the trials. In two of the three RCT, data were from subgroup analyses (patients not stratified by DIC).

The combined odds ratio for short-term all-cause mortality in those who received antithrombin was 0.649 (95% confidence interval, 0.422-0.998). Data on bleeding complications in patients treated with antithrombin were reported only in one of the trials and were not considered suitable for systematic safety estimation.

In sepsis patients with DIC, administration of antithrombin concentrate may increase overall survival. Current available evidence, however, is not suited to sufficiently inform clinical practice. [GTC and Leo Pharma hope to change this!]
<<

“The efficient-market hypothesis may be
the foremost piece of B.S. ever promulgated
in any area of human knowledge!”

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