Drotrecogin alfa: a new approach in the treatment of severe sepsis.
Severe sepsis is a common and frequently fatal condition. Evidence showing a link between the coagulation system and the inflammatory response to sepsis led to the development of drotrecogin alfa (activated) as an agent in the treatment of sepsis. This recombinant form of the natural protein, activated protein C (Xigris, Eli Lilly Co.), has been shown to significantly reduce mortality in a large randomised, controlled Phase III study involving 1690 patients. The exact mode of action of drotrecogin alfa (activated) remains uncertain, although it clearly combines anticoagulant and anti-inflammatory properties. Although associated with an increased risk of bleeding, this is usually procedure-related rather than spontaneous. Although costly, this is a drug that effectively reduces mortality rates in patients with severe sepsis.
Vincent
Jean-Louis
JL
Department of Intensive Care, Erasme University Hospital, Route de Lennik, 808, B-1070 Brussels, Belgium. jlvincen@ulb.ac.be
D000890:Anti-Infective Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006801:Humans; D007249:Inflammation; D011486:Protein C / Q000737:chemistry / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000737:chemistry / Q000627:therapeutic use*; D018805:Sepsis / Q000188:drug therapy*; D013997:Time Factors
D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated