Recombinant activated protein C: the key is clinical assessment of risk of death, not subset analysis.
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?
Section of Critical Care Medicine, Cooper University Hospital, One Cooper Plaza, Camden, NJ 08103, USA. dellinger-phil@cooperhealth.edu
R Phillip
RP
Dellinger
D006801:Humans; D011486:Protein C / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000401:mortality*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012307:Risk Factors; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy / Q000401:mortality
D011486:Protein C; D011994:Recombinant Proteins