Mode
Text Size
Log in / Sign up

Anisodamine hydrobromide plus standard therapy reduces 28-day mortality in septic shock (hazard ratio 0.64)Anisodamine hydrobromide reduces death rates in patients with septic shock

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Consider anisodamine hydrobromide as a potential adjunct to standard therapy to reduce 28-day mortality in septic shock.

This randomized controlled trial enrolled 296 patients with septic shock to evaluate the efficacy of anisodamine hydrobromide added to standard therapy. The primary outcome was 28-day all-cause mortality. The study also assessed secondary outcomes including lactate levels at 24 h and 72 h, and lactate clearance rates at 24 h.

Anisodamine hydrobromide significantly reduced 28-day mortality compared to the control group (hazard ratio 0.64; 95% confidence interval 0.43-0.95; P = 0.028). Sensitivity analysis for complete cases confirmed the robustness of these findings (hazard ratio 0.60; 95% confidence interval 0.40-0.91; P = 0.014).

Causal mediation analysis indicated that lactate at 24 h (explained 14.1% of the total effect; P = 0.042) and lactate clearance rate at 24 h (explained 17.3% of the total effect; P = 0.016) significantly mediated the protective effect. Lactate at 72 h also showed significant mediation (mediated proportion of 21.6%; P = 0.032).

Safety data, including adverse events and tolerability, were not reported. The study suggests that anisodamine hydrobromide may support the integration of this agent into sepsis management protocols. However, the extent of mediation is described as only partial.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in pharmacological interventions for septic shock, similar to the reported association of intravenous vitamin C with reduced mortality in patients with sepsis and septic shock. While vitamin C evidence is of low quality, this randomized controlled trial provides a specific hazard ratio of 0.64 for anisodamine. It also provides a different pharmacological approach compared to the mixed mortality outcomes seen with early vasopressin initiation.

Septic shock is a life-threatening medical emergency where the body's response to infection causes a dangerous drop in blood pressure. When patients face this crisis, every moment counts. A recent trial involving 296 patients looked at how adding a specific medication, anisodamine hydrobromide, to standard treatment might improve survival rates.

The study found that patients who received anisodamine hydrobromide along with standard therapy had a significantly lower risk of dying within 28 days compared to those who received standard therapy alone. The researchers also looked at lactate, which is a substance in the blood that helps doctors understand how much tissue damage is occurring during a severe infection.

Specifically, the study found that the way the body cleared lactate and the levels of lactate at 24 and 72 hours helped explain how the medication worked. While the study shows promising results for managing sepsis, it is important to note that these findings are based on a specific trial and should be discussed with medical professionals to see how they apply to specific patient needs.

What this means for you:
Adding anisodamine hydrobromide to standard care significantly reduces 28-day mortality in patients with septic shock.

Common questions

What is septic shock?

Septic shock is a severe and life-threatening condition caused by an extreme response to an infection. It causes a dangerous drop in blood pressure and can lead to organ failure. This trial focused on how to improve survival for these patients using a medication called anisodamine hydrobromide.

How did the medication affect survival rates?

The study of 296 patients found that adding anisodamine hydrobromide to standard therapy significantly reduced the risk of death within 28 days. The results showed a hazard ratio of 0.64, meaning it significantly improved outcomes compared to standard treatment alone.

What role did lactate play in the study?

Lactate is a substance that helps doctors measure tissue damage during infection. The study found that lactate levels at 24 and 72 hours, as well as the rate at which the body cleared lactate, helped explain how the medication provided its protective effects.

Study Details

Study typeRct
EvidenceLevel 2
PublishedSep 2026
View Original Abstract ↓
BackgroundThis randomized controlled trial evaluated whether anisodamine hydrobromide reduces 28-day mortality in septic shock and whether this effect is mediated by lactate and lactate clearance.MethodsIn this prospective randomized controlled trial, 296 patients with septic shock were randomly assigned to receive anisodamine hydrobromide plus standard therapy (n = 148) or standard therapy alone (n = 148). The primary outcome was 28-day all-cause mortality. Causal mediation analyses were performed to assess the mediating roles of lactate and lactate clearance rate at 24, 48, and 72 h.ResultsAnisodamine significantly reduced 28-day mortality compared with control (hazard ratio 0.64, 95% confidence interval 0.43–0.95; P = 0.028). Causal mediation analysis revealed that lactate at 24 h (average causal mediation effect −0.0166, P = 0.042) and lactate clearance rate at 24 h (average causal mediation effect −0.0206, P = 0.016) significantly mediated the protective effect, explaining 14.1% and 17.3% of the total effect, respectively. Lactate at 72 h also showed significant mediation (P = 0.032), with a mediated proportion of 21.6%. Sensitivity analysis using complete cases confirmed the robustness of these findings (hazard ratio 0.60, 95% confidence interval 0.40–0.91; P = 0.014), with consistent mediation effects for lactate and lactate clearance at 24 h.ConclusionAnisodamine hydrobromide significantly reduces 28-day mortality in patients with septic shock, with effects partially mediated by lactate and lactate clearance at 24 h. These findings support the integration of anisodamine into sepsis management protocols.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.