Why anticoagulant studies on sepsis fail frequently --- start with SCARLET
The Sepsis Coagulopathy Asahi Recombinant LE Thrombomodulin (SCARLET) trial has many defects, and thus cannot be the terminator of recombinant thrombomodulin (rTM). On the contrary, it provides sufficient evidence for further research. Based on analysis focusing on the failure of SCARLET and several...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Chinese Journal of Traumatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1008127523000421 |
| _version_ | 1797679523418865664 |
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| author | Jian-Ying Guo Hong-Yuan Lin |
| author_facet | Jian-Ying Guo Hong-Yuan Lin |
| author_sort | Jian-Ying Guo |
| collection | DOAJ |
| description | The Sepsis Coagulopathy Asahi Recombinant LE Thrombomodulin (SCARLET) trial has many defects, and thus cannot be the terminator of recombinant thrombomodulin (rTM). On the contrary, it provides sufficient evidence for further research. Based on analysis focusing on the failure of SCARLET and several previous anticoagulant studies, it is most important for new studies to grasp the following two points: (1) The enrolled cases should have sufficient disease severity and a clear standard for disseminated intravascular coagulation; (2) Heparin should not be used in combination with the investigated drugs. Multiple post-hoc analyses show that no combination of heparin will not increase the risk of thromboembolism. In fact, the combination of heparin can mask the true efficacy of the investigated drug. Due to the complexity of sepsis treatment and the limitations of clinical studies, the results of all treatment studies should be repeatedly verified, rather than be determined at one stroke. Some research conclusions contrary to disease physiology, pharmacology and clinical practice may be deceptive, and should be cautious rather than be simply accepted. On the other hand, the dissenting voices in the “consensus” scene are often well discussed by the authors and should be highly valued. |
| first_indexed | 2024-03-11T23:16:00Z |
| format | Article |
| id | doaj.art-d793d3324e90467992fcdc3a7eb26b65 |
| institution | Directory Open Access Journal |
| issn | 1008-1275 |
| language | English |
| last_indexed | 2024-03-11T23:16:00Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj.art-d793d3324e90467992fcdc3a7eb26b652023-09-21T04:36:15ZengElsevierChinese Journal of Traumatology1008-12752023-09-01265297302Why anticoagulant studies on sepsis fail frequently --- start with SCARLETJian-Ying Guo0Hong-Yuan Lin1Department of the Intensive Care Unit, The Fourth Medical Center of General Hospital of PLA, 100048, Beijing, ChinaCorresponding author.; Department of the Intensive Care Unit, The Fourth Medical Center of General Hospital of PLA, 100048, Beijing, ChinaThe Sepsis Coagulopathy Asahi Recombinant LE Thrombomodulin (SCARLET) trial has many defects, and thus cannot be the terminator of recombinant thrombomodulin (rTM). On the contrary, it provides sufficient evidence for further research. Based on analysis focusing on the failure of SCARLET and several previous anticoagulant studies, it is most important for new studies to grasp the following two points: (1) The enrolled cases should have sufficient disease severity and a clear standard for disseminated intravascular coagulation; (2) Heparin should not be used in combination with the investigated drugs. Multiple post-hoc analyses show that no combination of heparin will not increase the risk of thromboembolism. In fact, the combination of heparin can mask the true efficacy of the investigated drug. Due to the complexity of sepsis treatment and the limitations of clinical studies, the results of all treatment studies should be repeatedly verified, rather than be determined at one stroke. Some research conclusions contrary to disease physiology, pharmacology and clinical practice may be deceptive, and should be cautious rather than be simply accepted. On the other hand, the dissenting voices in the “consensus” scene are often well discussed by the authors and should be highly valued.http://www.sciencedirect.com/science/article/pii/S1008127523000421SepsisDisseminated intravascular coagulationCoagulopathyAnti-coagulation |
| spellingShingle | Jian-Ying Guo Hong-Yuan Lin Why anticoagulant studies on sepsis fail frequently --- start with SCARLET Chinese Journal of Traumatology Sepsis Disseminated intravascular coagulation Coagulopathy Anti-coagulation |
| title | Why anticoagulant studies on sepsis fail frequently --- start with SCARLET |
| title_full | Why anticoagulant studies on sepsis fail frequently --- start with SCARLET |
| title_fullStr | Why anticoagulant studies on sepsis fail frequently --- start with SCARLET |
| title_full_unstemmed | Why anticoagulant studies on sepsis fail frequently --- start with SCARLET |
| title_short | Why anticoagulant studies on sepsis fail frequently --- start with SCARLET |
| title_sort | why anticoagulant studies on sepsis fail frequently start with scarlet |
| topic | Sepsis Disseminated intravascular coagulation Coagulopathy Anti-coagulation |
| url | http://www.sciencedirect.com/science/article/pii/S1008127523000421 |
| work_keys_str_mv | AT jianyingguo whyanticoagulantstudiesonsepsisfailfrequentlystartwithscarlet AT hongyuanlin whyanticoagulantstudiesonsepsisfailfrequentlystartwithscarlet |