TIGRIS and EUPHRATES eventually join and provide new evidence : a narrative review of the polymyxin B hemoperfusion
Iba, Toshiaki (Juntendō Daigaku)
Helms, Julie (Université de Strasbourg)
Nagaoka, Isao (Juntendō Daigaku)
Mineshima, Michio (Juntendō Daigaku)
Ferrer, Ricard (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona. Departament de Medicina

Fecha:	2025
Descripción:	7 pàg.
Resumen:	Septic shock driven by endotoxemia is associated with high mortality despite advances in supportive care. Polymyxin B hemoperfusion (PMX-HP) selectively removes circulating endotoxin and has shown variable efficacy in randomized trials. While earlier studies, such as EUPHAS, suggested benefit, subsequent trials, including ABDO-MIX and EUPHRATES, yielded neutral results, partly due to heterogeneous patient selection. The recently completed TIGRIS trial addressed these limitations by enrolling septic shock patients with intermediate endotoxin activity (EAA: 0. 60-0. 89) and high multiple organ dysfunction syndrome (MODS>9) using a Bayesian design. In 151 evaluable patients, PMXHP achieved the primary endpoint, with a 95. 3% posterior probability of 28-day survival benefit (adjusted odds ratio [OR]: 0. 67; absolute risk reduction [ARR] 6. 4%). At 90 days, mortality reduction was greater (ARR: 17. 4%; adjusted OR: 0. 54;>99% posterior probability of benefit), corresponding to a number needed to treat of 8. 1. These results support the targeted use of PMX-HP in a biomarker-defined subgroup and may facilitate broader regulatory approval.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Endotoxin ; Extracorporeal circulation ; Sepsis ; Shock ; Biomarker
Publicado en:	Journal of Intensive Care, Vol. 13 (November 2025) , art. 67, ISSN 2052-0492

DOI: 10.1186/s40560-025-00835-6
PMID: 41291942

7 p, 673.7 KB

El registro aparece en las colecciones:
Artículos > Artículos de investigación
Artículos > Artículos publicados