Navigation Links
Anti-clotting agent does not improve outcomes of patients with severe pneumonia
Date:2/22/2011

Use of the blood clot-inhibiting medication tifacogin does not appear to improve outcomes of patients with severe community-acquired pneumonia (sCAP), according to a study conducted by researchers from North and South America, Europe, Asia and Africa. The drug had shown some potential benefit in the sCAP subgroup of an earlier trial involving sepsis patients.

The findings were published online ahead of the print edition of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

"Administration of tifacogin showed no treatment benefit in this large population of patients with severe CAP,"said Richard Wunderink, MD, professor of pulmonary and critical care medicine at Northwestern University's Feinberg School of Medicine. "This result was consistent across a range of disease severity indices."

In the U.S., community-acquired pneumonia (CAP) is the eighthleading cause of death, with a death rate of 18.8/100,000. The number of individuals hospitalized with CAP annually is expected to increase up to 1 million in 2020, with similar trends in many other countries due to the disproportionate growth of the elderly population. Globally, intensive care unit mortality in patients admitted with sCAP is about 30%.

In most sCAP patients, the blood clotting system is activated as part of the response to infection, in some cases interfering with circulation and leading to multiple organ failure. Researchers hope reducing this excess clottingthrough use of anticoagulants in individuals with sCAP may prevent organ failure.

Tifacoginacts by blocking activated tissue factor, an essential for clot formation. In aprior trial of sepsis patients, tifacogin had shown some benefit for patients in that trial who had CAP. Based on those results, Dr. Wunderink said researchers involved in this study, dubbed CAPTIVATE (Community-Acquired Pneumonia Tifacogin Intra-Venous Administration Trial for Efficacy), aimed to assess the efficacy and safety of tifacogin as adjunct therapy in sCAP.

"CAP remains the most common cause of death from infection," Dr. Wunderink said. "Anti-clotting therapies are sought to complement the antimicrobial treatment and supportive care measures that are currently used for sCAP patients."

In this study, researchers enrolled 2,138 sCAPpatients from 188 centers from 2005 to 2008, randomizing them to receive tifacogin or placebo intravenously for four days. Although two doses of tifacogin (0.025 mg/kg/h and 0.075 mg/kg/h) were initially included in the study, the higher dose was dropped early on when no benefit was demonstrated.

At the end of the study although tifacogin did show an effect on clotting measures in the blood, the researchers found mortality rates and the incidence of adverse events were similar in both the tifacogin and placebo groups.

Dr. Wunderink said the study's negative results could be due to several factors.

"The coagulation and inflammatory responses may have been irreversibly activated before tifacogin was administered, or specific processes that occur during CAP may have blunted the effect of the drug," he said. "However, the most logical explanation is that tissue factor activation, while important, may not be a critical step in the pathogenesis of sCAP mortality."

Although the study showed no benefit associated with the use of tifacogin in sCAP patients, Dr. Wunderink said it clearly demonstrates the need for additional research to improve sCAP mortality rates.

"CAPTIVATE represents the largest clinical trial of severe CAP performed to date," Dr. Wunderink said. "The design and execution of the study demonstrates that a more homogeneous population with a single source ofinfection, rather than a more generic sepsis population, can be defined, which will be of benefit for future studies.

"Although theprimary end-point was not achieved, this study demonstrates the persistent unmet need forfurther interventions to improve mortality of sCAP and the feasibility of those studies," he added.


'/>"/>

Contact: Brian Kell
bkell@thoracic.org
212-316-6442
American Thoracic Society
Source:Eurekalert

Related medicine news :

1. New Anti-Clotting Drug May Work Better After Hip Replacement
2. Extended use of anti-clotting drug helps some bedridden patients
3. Tests to Measure Safety of Anti-Clotting Drugs of Limited Value
4. VCU Massey first to combine targeted agents to kill multiple myeloma cells
5. SNM applauds FDA advisory committee recommendation for approval of Alzheimers imaging agent
6. Study provides molecular rationale for combining targeted agents to treat breast cancer
7. Colorectal cancer patients with gene mutation show better response to cancer agent
8. Targeted agent shows promise for chronic lymphoid leukemia
9. Agent Orange exposure linked to Graves disease in Vietnam veterans, UB study finds
10. New Research Uncovers Elusive Target of Antifungal Agent
11. Compound enhances cancer-killing properties of agent in trials
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/8/2016)... ... 08, 2016 , ... Stephanie Hebert Insurance Agency, serving families ... new charity campaign. As part of their ongoing community involvement program, funds are ... that children deserve a voice, and in the spirit of neighbors helping neighbors ...
(Date:2/8/2016)... ... February 08, 2016 , ... ... expansion into Canada to provide its range of unique and advantaged protective ... Quebec City that will provide bilingual customer service and marketing support. A new ...
(Date:2/8/2016)... ... February 08, 2016 , ... ... announced today that nominations will be accepted February 8, 2016 through May ... , Awards include the Information Security Executive® of the Year, which recognizes ...
(Date:2/8/2016)... ... February 08, 2016 , ... ... lower incidence rate of type 2 diabetes in the GrassrootsHealth cohort with substantially ... to make a change in public health,” states Carole Baggerly, Director of GrassrootsHealth, ...
(Date:2/8/2016)... , ... February 08, 2016 , ... The schedule ... in this country. The AutismOne 2016 Conference, which is being held May 25-29 at ... won’t hear elsewhere about helpful interventions and causes of chronic illness in children. , ...
Breaking Medicine News(10 mins):
(Date:2/8/2016)... DIEGO , Feb. 8, 2016  Neurocrine Biosciences, ... Company will report its fourth quarter and year-end 2015 ... 11, 2016.  Neurocrine will then host a live conference ... provide a Company update Thursday afternoon, February 11, 2016 ... http://www.neurocrine.com . --> http://www.neurocrine.com . ...
(Date:2/8/2016)... --> --> ... Technologies Market by Product (Radiofrequency, Ultrasound, Irreversible Electroporation, Cryotherapy, ... Ophthalmology, Gynecology) - Global Forecasts to 2020", published by ... forecast period of 2015 to 2020. The market is ... of 10.5% from 2015 to 2020. Browse ...
(Date:2/8/2016)... Feb. 8, 2016 Nueterra, the ... specialized in the development of equity partnerships ... it has divided its interests between two ... Capital will continue the founding company,s private ... operate a national system of integrated provider ...
Breaking Medicine Technology: