• Shahzad G Raja and Gilles D Dreyfus.
• Department of Cardiothoracic Surgery, Harefield Hospital, Harefield, Middlesex, UK.
• Core Evid. 2008 Jan 1;2(3):199-207.

IntroductionSepsis and its sequelae are the leading causes of morbidity and mortality in critically ill patients. The burden to healthcare economies is also considerable. As the pathophysiology of sepsis is better defined, interventions aiming to treat sepsis are emerging. Eritoran (E5564), a toll-like receptor 4 (TLR4)-directed endotoxin antagonist, is one such emerging therapeutic option for treatment of sepsis.AimsThis review assesses evidence for the potential therapeutic value of eritoran in the management of sepsis.Evidence ReviewEvidence from a single phase II trial of eritoran usage in sepsis suggests that it is a safe and effective therapeutic option for patients with sepsis, and is especially beneficial for patients at high risk of mortality. However, the cost effectiveness of eritoran and its place in therapy compared with other available treatment options and those currently in development remains to be determined.Clinical PotentialEritoran is a potential therapeutic option for management of sepsis and other TLR4- and lipopolysaccharide-mediated disorders with a reasonable safety and tolerability profile that must be validated by several rigorous, blinded, placebo-controlled, adequately powered, multicenter, randomized clinical trials.

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