• Annals of medicine · Jan 2023

    Randomized Controlled Trial Multicenter Study

    Anisodamine hydrobromide in the treatment of critically ill patients with septic shock: a multicenter randomized controlled trial.

    • Fang Zhang, Xue Mei, Ping Zhou, Ying-Ping Tian, Jin-Xiang Liu, Xu Dong, Ding-Shan Yuan, Zhao-Fen Lin, Lei Zhang, Jin-Hao Lin, Ai-Jun Li, Xing Deng, Ming-Zhi Chen, Shi-Ying Yuan, Jun-Jing Zha, Bin Shi, Zhi-Hong Lin, and Shu-Bin Guo.
    • Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
    • Ann. Med. 2023 Jan 1; 55 (2): 22643182264318.

    BackgroundSeptic shock is the development of sepsis to refractory circulatory collapse and metabolic derangements, characterized by persistent hypotension and increased lactate levels. Anisodamine hydrobromide (Ani HBr) is a Chinese medicine used to improve blood flow in circulatory disorders. The purpose of this study was to determine the therapeutic efficacy of Ani HBr in the treatment of patients with septic shock.MethodsThis was a prospective, multicenter, randomized controlled trial focusing on patients with septic shock in 16 hospitals in China. Patients were randomly assigned in a 1:1 ratio to either the treatment group or the control group. The primary endpoint was 28-day mortality. The secondary outcomes included 7-day mortality, hospital mortality, hospital length of stay, vasopressor-free days within 7 days, etc. These indicators were measured and collected at 0, 6h, 24h, 48h, 72h and 7d after the diagnosis.ResultsBetween September 2017 and March 2021, 404 subjects were enrolled. 203 subjects received Ani HBr and 201 subjects were assigned to the control group. The treated group showed lower 28-day mortality than the control group. Stratified analysis further showed significant differences in 28-day mortality between the two groups for patients with a high level of illness severity. We also observed significant differences in 7-day mortality, hospital mortality and some other clinical indicators between the two groups.ConclusionAni HBr might be an important adjuvant to conventional treatment to reduce 28-day mortality in patients with septic shock. A large-scale prospective randomized multicenter trial is warranted to confirm our results.

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