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Evidence summaries

Drotrecogin Alfa for Severe Sepsis in Adults

Drotrecogin alfa (activated) appears to reduce mortality in severe sepsis. Level of evidence: "B"

A systematic review 1 including 2 studies with a total of 1821 subjects was abstracted in DARE. The combined overall 28-day mortality rate was 25.1% in patients treated with drotrecogin alfa (activated) and 31.0% in those treated with placebo (RR 0.81, 95% CI: 0.70 to 0.94). Based on data from all available clinical studies, 2.3% of patients on placebo experienced a serious bleeding event, compared with 5.3% of those who had received drotrecogin alfa (activated).

Comment: The quality of evidence is downgraded by indirectness (lack of reporting corticosteroid use which may affect mortality).

    References

    • Green C, Dinnes J, Takeda A, Shepherd J, Hartwell D, Cave C, Payne E, Cuthbertson BH. Clinical effectiveness and cost-effectiveness of drotrecogin alfa (activated) (Xigris) for the treatment of severe sepsis in adults: a systematic review and economic evaluation. Health Technol Assess 2005 Mar;9(11):1-126, iii-iv. [PubMed] [DARE]

Primary/Secondary Keywords