Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Critical Care
Published in: Critical Care 1/2006

01-02-2006 | Commentary

Recombinant activated protein C: the key is clinical assessment of risk of death, not subset analysis

Author: R Phillip Dellinger

Published in: Critical Care | Issue 1/2006

Login to get access

Abstract

The PROWESS (Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis) trial demonstrated a 6.1% absolute decrease in mortality with a p value of 0.005. Despite the impressive results of this trial, criticism of the study has targeted various aspects of design, analysis and interpretation. Additional studies of recombinant activated protein C (rhAPC) have added to our understanding about this drug and to controversy as well. So how do we deal with rhAPC use in our clinical practice?
Literature
1.
Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF, Lopez-Rodriguez A, Steingrub JS, Garber GE, Helterbrand JD, Ely EW, et al.: Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001, 344: 699-709. 10.1056/NEJM200103083441001CrossRefPubMed
2.
Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, Gea-Banacloche J, Keh D, Marshall JC, Parker MM, et al.: Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med 2004, 32: 858-873. 10.1097/01.CCM.0000117317.18092.E4CrossRefPubMed
3.
Vincent JL, Bernard GR, Beale R, Doig C, Putensen C, Dhainaut JF, Artigas A, Fumagalli R, Macias W, Wright T, et al.: Drotrecogin alfa (activated) treatment in severe sepsis from the global open-label trial ENHANCE: further evidence for survival and safety and implications for early treatment. Crit Care Med 2005, 33: 2266-2277. 10.1097/01.CCM.0000181729.46010.83CrossRefPubMed
4.
Abraham E, Laterre PF, Garg R, Levy H, Talwar D, Trzaskoma BL, Francois B, Guy JS, Bruckmann M, Rea-Neto A, et al.: Drotreco-gin alfa (activated) for adults with severe sepsis and a low risk of death. N Engl J Med 2005, 353: 1332-1341. 10.1056/NEJMoa050935CrossRefPubMed
5.
6.
Ely EW, Laterre PF, Angus DC, Helterbrand JD, Levy H, Dhainaut JF, Vincent JL, Macias WL, Bernard GR: Drotrecogin alfa (activated) administration across clinically important subgroups of patients with severe sepsis. Crit Care Med 2003, 31: 12-19. 10.1097/00003246-200301000-00002CrossRefPubMed
Metadata
Title
Recombinant activated protein C: the key is clinical assessment of risk of death, not subset analysis
Author
R Phillip Dellinger
Publication date
01-02-2006
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2006
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc3991

Other articles of this Issue 1/2006

Critical Care 1/2006 Go to the issue

Review

Direct patient care during an acute disaster: chasing the will-o'-the-wisp

Research

The clinical value of daily routine chest radiographs in a mixed medical–surgical intensive care unit is low

Review

Bench-to-bedside review: Early tracheostomy in critically ill trauma patients

Research

Impact of computerized physician order entry on medication prescription errors in the intensive care unit: a controlled cross-sectional trial

Research

CC and CXC chemokine levels in children with meningococcal sepsis accurately predict mortality and disease severity

Research

Systematic review of determinants of mortality in high frequency oscillatory ventilation in acute respiratory distress syndrome