Does Landiolol improve outcomes in Septic Shock? Insights from JAMA study

A new study published in JAMA has found that the beta-blocker landiolol does not improve outcomes in patients with septic shock. The study was stopped early due to a signal of possible harm, with mortality rates higher in the landiolol group than in the standard care group.

The study involved 126 patients with septic shock who were randomized to receive either landiolol infusion or standard care. The primary outcome was the mean Sequential Organ Failure Assessment (SOFA) score from randomization through 14 days. Secondary outcomes included mortality at days 28 and 90 and the number of adverse events in each group.

There was no difference in the mean SOFA score between the two groups. Mortality at day 28 was 37.1% in the landiolol group and 25.4% in the standard care group, and mortality at day 90 was 43.5% in the landiolol group and 28.6% in the standard care group.

The authors of the study conclude that landiolol should not be used for managing tachycardia among patients treated with norepinephrine for established septic shock.

This study is important because it provides high-quality evidence against the use of landiolol in septic shock. Landiolol is a widely used beta-blocker, and this study suggests that it may be harmful in this setting. Clinicians should be aware of these findings and should not use landiolol in patients with septic shock.

Reference: Whitehouse T, Hossain A, Perkins GD, et al. Landiolol and Organ Failure in Patients with Septic Shock: The STRESS-L Randomized Clinical Trial. JAMA. Published online October 25, 2023. DOI: 10.1001/jama.2023.20134