Levosimendan Investigated in Patients with Septic Shock
(HealthDay News) — For adults with sepsis, levosimendan does not prevent acute organ dysfunction, according to a study published online Oct. 5 in the New England Journal of Medicine to coincide with the European Society of Intensive Care Medicine Annual Congress, held from Oct. 1 to 5 in Milan.
Anthony C. Gordon, M.D., from Charing Cross Hospital in London, and colleagues conducted a randomized trial involving adult patients with sepsis. In addition to standard care, patients were randomized to receive either a blinded infusion of levosimendan for 24 hours (259 patients) or placebo (257 patients).
The researchers found that the mean Sequential Organ Failure Assessment score did not differ significantly between the groups (mean difference, 0.61; P = 0.053). Mortality at 28 days was 34.5 and 30.9 percent in the levosimendan and placebo groups, respectively (P = 0.43). Among those requiring ventilation at baseline, the likelihood of being successfully weaned from mechanical ventilation over 28 days was lower in the levosimendan group (hazard ratio, 0.77; P = 0.03). Supraventricular tachyarrhythmia occurred in more patients in the levosimendan group (3.1 versus 0.4 percent; P = 0.04).
"The addition of levosimendan to standard treatment in adults with sepsis was not associated with less severe organ dysfunction or lower mortality," the authors write. "Levosimendan was associated with a lower likelihood of successful weaning from mechanical ventilation and a higher risk of supraventricular tachyarrhythmia."
Several authors disclosed financial ties to pharmaceutical companies, including Tenax, which developed levosimendan and provided funding for the study.