Document Detail


Drotrecogin alfa (activated): a novel therapeutic strategy for severe sepsis.
MedLine Citation:
PMID:  12566544     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent studies have highlighted the close link between activation of the coagulation system and the inflammatory response in the pathophysiology of severe sepsis. The protein C anticoagulant pathway plays an integral part in modulating the coagulation and inflammatory responses to infection. In patients with sepsis, endogenous protein C levels are decreased, shifting the balance toward greater systemic inflammation, coagulation, and cell death. On the basis of a single large randomised phase 3 trial, drotrecogin alfa (activated), a recombinant form of human activated protein C, was recently approved for the treatment of adult patients with severe sepsis and a high risk of death. Since its approval, several questions have been raised regarding the appropriate use of this agent. Given the increased risk of serious bleeding and the high cost of treatment, drotrecogin alfa (activated) should be reserved at this time for the most acutely ill patients with severe sepsis who meet the criteria that were used in the phase 3 trial.
Authors:
S M Pastores
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Postgraduate medical journal     Volume:  79     ISSN:  0032-5473     ISO Abbreviation:  Postgrad Med J     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-02-04     Completed Date:  2003-04-17     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0234135     Medline TA:  Postgrad Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  5-10     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. pastores@mskcc.org
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MeSH Terms
Descriptor/Qualifier:
Anti-Infective Agents / therapeutic use*
Blood Coagulation
Clinical Trials as Topic
Humans
Protein C / physiology,  therapeutic use*
Recombinant Proteins / therapeutic use*
Sepsis / blood,  drug therapy*
Chemical
Reg. No./Substance:
0/Anti-Infective Agents; 0/Protein C; 0/Recombinant Proteins; 0/drotrecogin alfa activated
Comments/Corrections

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