To: Robert K. who wrote (8398 ) 1/21/1999 2:18:00 PM From: Cacaito Respond to of 17367
Some therapeutic interventions in sepsis undergoing clinical trials: Lipopolysaccharide analogues (ABTI like failure) High-density lipoprotein (?) Haemoperfusion with polymyxin B (similar processes-failure) Polymyxin B linked to dextran (dextran will give problem in sepsis due to chances of overvolume due to high osmolality of dextran) Bactericidal permeability increasing protein (The clear FUTURE winner, all disclaimers apply) Anti-TNF antibodies (failure, but Embrel is approved for Rheumatoid Arthritis, from IMNX) TNF receptor p55 (failure with antibody blocker, chance here?) Corticosteroids (they are immunosuppresives, lots of side effects, timing is extremely important, already proven to increase death, but LGND has a small molecule rexinoid that theoretically will give pintpoin antiinflamatory activity and no side effects, they are aiming for chronic diseases and as substitutes of Motrin like drugs, but theoretical chances are there, trials are far,far far in the future.) Inhibitors of nitric-oxide (NO) synthase (three diferent enzymes, they interact and overlap, timing is critical and still at very basic research in animals) Haemoglobin solutions (as NO scavengers, remember Baxter Hb based blood replacement product and increase mortality, lack of inform consent, zero chances) Granulocyte-colony-stimulating factor (they are already proven not to work in severely acute conditions, they take long time to work, Amgen and Imnx are making tons of money in the chronic cancer market even ther the evidence is marginal, just enough for FDA approval). Antithrombin III (along will go nowhere, in combination is too complex) activated factor C (same as above) tissue-factor-pathway inhibitor (?, got to check this one). Antioxidants (procysteine - Failure) Immunonutrition (fish oil need to be higly purified not to be toxic or allergic good for the antiFDA champs, Antioxidants - nothing with this activity works well in humans, but good for cadillac engines) Lisofylline (anti-TNF agent, they say so to put a scam in the market and miserably failed) Recombinant platelet-activating-factor inhibitor ( ICOS multipurpose drug, they have a chance in sepsis, in theory should be synergistic with BPI, in combination with BPI after BPI approval, maybe if ICOS drop its research We can pick up the license and IPO a biotech, But the cousin product Direct PLA receptor blocker did not work, go back and check the report from France I post a week ago). All disclaimers apply.