Effectiveness of early recombinant human soluble thrombomodulin supplementation in septic disseminated intravascular coagulation cases after surgical interventions for infection

早苗, 細見; 浩士, 林下

doi:10.3918/jsicm.21.623

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…Finally, 11 studies were included in the qualitative synthesis [ 13 – 16 , 19 – 25 ]. Amongst these, four reported only unadjusted results [ 19 , 21 , 22 , 24 ]; hence, seven studies were included in the quantitative synthesis (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Effects of combination therapy of antithrombin and thrombomodulin for sepsis-associated disseminated intravascular coagulation: a systematic review and meta-analysis

Totoki,

Makino,

Yamakawa

et al. 2024

Thrombosis J

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Background Disseminated intravascular coagulation (DIC) syndrome is a highly lethal condition characterized by the complication of multiple organ damage. Although the effects of combined antithrombin (AT) and recombinant thrombomodulin (rTM) on DIC syndrome have previously been examined, the results are inconsistent and inconclusive. Therefore, we conducted a systematic review on the combined administration of AT and rTM for the treatment of septic DIC to investigate the superiority of the combination therapy over either AT or rTM monotherapy using a random-effects analysis model. Method We searched electronic databases, including Medline, Cochrane Central Register of Controlled Trials, Scopus, and Igaku-Chuo Zasshi (ICHU-SHI) Japanese Central Review of Medicine Web from inception to January 2022. Studies assessing the efficacy of combined AT and rTM were included. The primary outcome was all-cause mortality, and the secondary outcome was occurrence of serious bleeding complications compared to monotherapy. We presented the pooled odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CI) depending on reporting results in each primary study. Results We analyzed seven enrolled clinical trials, all of which were observational studies. Combination therapy had a non-significant favorable association with lower 28-day mortality compared to monotherapy (HR 0.67 [0.43–1.05], OR 0.73 [0.45–1.18]). The I2 values were 60% and 72%, respectively, suggesting high heterogeneity. As a secondary outcome, bleeding complications were similar between the two groups (pooled OR 1.11 [0.55–2.23], I2 value 55%). Conclusions Although the findings in this analysis could not confirm a statistically significant effect of AT and rTM combination therapy for septic DIC, it showed a promising effect in terms of improving mortality. The incidence of bleeding was low and clinically feasible. Further research is warranted to draw more conclusive results. Trial registration This study was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN ID: 000049820).

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Section: Resultsmentioning

confidence: 99%

Effects of combination therapy of antithrombin and thrombomodulin for sepsis-associated disseminated intravascular coagulation: a systematic review and meta-analysis

Totoki,

Makino,

Yamakawa

et al. 2024

Thrombosis J

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“…Finally, 11 studies were included in the qualitative synthesis ([13-16, 19-25]). Of the included studies, four reported only unadjusted results ( [19,21,22,24]); hence, seven studies were included in the quantitative synthesis (Fig. 1).…”

Section: Literature Searchmentioning

confidence: 99%

Effects of combination therapy of Antithrombin and Thrombomodulin for Sepsis-associated Disseminated Intravascular Coagulation: A Systematic Review and Meta-analysis

Totoki,

Makino,

Yamakawa

et al. 2023

Preprint

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Background Disseminated intravascular coagulation (DIC) syndrome is a highly lethal condition characterized by the complication of multiple organ damage. Although some studies have examined the effects of combined antithrombin (AT) and recombinant thrombomodulin (rTM) in clinical practice, the results are inconsistent and inconclusive. Therefore, we conducted a systematic review of the combined administration of AT and rTM in treating septic DIC to investigate the usefulness of the combination therapy by random-effects analysis model. Method We searched electronic databases, including Medline, Cochrane Central Register of Controlled Trials, Scopus, and Igaku-Chuo Zasshi (ICHU-SHI) Japanese Central Review of Medicine Web from inception to January 2022. Studies assessing the efficacy of combined AT and rTM were included. The primary outcome was all-cause mortality, and the secondary outcome was serious bleeding complications. We presented the pooled odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CI) depending on reporting results in each primary study. Results We analyzed seven enrolled clinical trials, all of which were observational studies. Combination therapy had a non-significant favorable association with lower 28-day mortality compared to monotherapy(HR 0.67 [0.43–1.05], OR 0.73 [0.45–1.18].)The I2 values were 60 and 72%, respectively, suggesting high heterogeneity. Trial registration This study was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN ID: 000049820).

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Septic disseminated intravascular coagulation (DIC) and thrombomodulin

泰之¹

2014

Nihon Shuchu Chiryo Igakukai zasshi

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Effectiveness of early recombinant human soluble thrombomodulin supplementation in septic disseminated intravascular coagulation cases after surgical interventions for infection

Cited by 3 publications

References 18 publications

Effects of combination therapy of antithrombin and thrombomodulin for sepsis-associated disseminated intravascular coagulation: a systematic review and meta-analysis

Effects of combination therapy of antithrombin and thrombomodulin for sepsis-associated disseminated intravascular coagulation: a systematic review and meta-analysis

Effects of combination therapy of Antithrombin and Thrombomodulin for Sepsis-associated Disseminated Intravascular Coagulation: A Systematic Review and Meta-analysis

Septic disseminated intravascular coagulation (DIC) and thrombomodulin

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