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PROWESS - Activated Protein C

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PROWESS. Efficacy and Safety of Recombinant Human Activated Protein C for Severe Sepsis. NEJM 2001; 344: 699.

Background: Drotrecogin alfa (activated) has antithrombotic, antiinflammatory, and profibrinolytic properties. This phase 3 trial was designed to assess if DAA would reduce the rate of death in patients with severe sepsis.

Methods: Randomized, double-blind, placebo-controlled, multicenter trial. Three out of four SIRS criteria and organ failure were used as entry criteria. n = 1690.

Treatment: DAA was started within 24 hours of diagnosis, dosed at 24 micrograms per kilogram per hour for a total of 96 hours.

Results: Mortality was 24.7 v 30.8%. ARR 6.1%, p = 0.005. NNT = 16

Adverse Events: Serious bleeding event was 3.5 v 2.0%. ARI 1.5%, p = 0.06. NNH =  7

 

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