Iloprost fails to Improve organ function in patients with septic shock and severe endotheliopathy: JAMA

A recent clinical trial published in the Journal of American Medical Association revealed that the drug iloprost, commonly used to treat vascular conditions, does not improve organ function in patients with septic shock and severe endotheliopathy. The study was conducted across 6 hospitals in Denmark to explore whether iloprost could help reduce organ dysfunction in patients with elevated levels of soluble thrombomodulin which is a marker of endotheliopathy. However, the results showed no significant difference between the iloprost-treated group and the ones receiving a placebo.

This double-blinded trial ran from November 2019 to July 2022 and included a total of 279 adult ICU patients diagnosed with septic shock and severe endotheliopathy by plasma soluble thrombomodulin levels greater than 10 ng/mL. The patients were randomly assigned to receive either iloprost which was administered via intravenous infusion at a dosage of 1 ng/kg/min for 72 hours, or a placebo. The primary objective was to assess the impact of iloprost on the severity of organ failure which was measured by the Sequential Organ Failure Assessment (SOFA) score is a common scale used to evaluate organ dysfunction in critical care. Secondary outcomes included mortality at 90 days and the occurrence of serious adverse events or reactions.