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Titolo:
Anti-tumor necrosis factor therapy in sepsis: Update on clinical trials and lessons learned
Autore:
Reinhart, K; Karzai, W;
Indirizzi:
Univ Hosp Jena, Dept Anesthesiol & Intens Care Med, Jena, Germany Univ Hosp Jena Jena Germany nesthesiol & Intens Care Med, Jena, Germany
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 7, volume: 29, anno: 2001, supplemento:, S
pagine: S121 - S125
SICI:
0090-3493(200107)29:7<S121:ANFTIS>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
COLONY-STIMULATING FACTOR; SEPTIC SHOCK; FACTOR-ALPHA; MONOCLONAL-ANTIBODY; ESCHERICHIA-COLI; FUSION PROTEIN; CANINE MODEL; DOUBLE-BLIND; TNF-ALPHA; ENDOTOXIN;
Keywords:
sepsis; tumor necrosis factor; anti-tumor necrosis factor therapy; monoclonal antibodies; tumor necrosis factor receptor proteins;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Reinhart, K FSU Jena Klinikum, Klin Anasthesiol & Intens Therapie, Bachstr18, D-07740Jena, Germany FSU Jena Klinikum Bachstr 18 Jena Germany D-07740 na, Germany
Citazione:
K. Reinhart e W. Karzai, "Anti-tumor necrosis factor therapy in sepsis: Update on clinical trials and lessons learned", CRIT CARE M, 29(7), 2001, pp. S121-S125

Abstract

Objective: Tumor necrosis factor (TNF) is an important mediator involved in the pathogenesis of sepsis, We review clinical studies investigating the efficacy of anti-TNF therapy in decreasing mortality rates in septic patients. Data Sources: We conducted a computerized bibliographic search of randomized, clinical, multicenter trials studying the effects of anti-TNF therapy in the treatment of sepsis, We included all primary studies, reviewed all published meta-analyses, and contacted primary investigators of multicenter trials where necessary. Data Synthesis, Almost all randomized studies targeting TNF during sepsis show a small, albeit nonsignificant, benefit in decreasing mortality, Strategies using monoclonal antibodies are more effective than are strategies using TNF receptor proteins. Analysis of randomized multicenter trials shows a small hut significant benefit with anti-TNF therapeutic strategies. Furthermore, a recent study in 2634 septic patients using a murine anti-TNF antibody shows a 3.6% significant benefit in reducing mortality. Conclusions: Anti-TNF strategies are only partially effective in patients with sepsis, Although individual studies show small, nonsignificant benefits, analysis of all trial data as well as data from a recent trial in a large population of septic patients show that anti-TNF strategies may confer a small survival benefit. Better characterization of patients and a more multimodal approach by concomitantly targeting other mediators involved in sepsis may be helpful in enlarging the clinical benefit of anti-TNF therapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 09:56:33