A major review of 76 randomized trials involving over 22,000 sepsis patients examined four immunomodulatory drugs. These included ulinastatin, thymosin-α1, polyunsaturated fatty acids (PUFA), and monoclonal antibodies. The goal was to see how they affected death rates and other key outcomes.
The strongest result was for ulinastatin alone, which cut the risk of death by about 63% compared to other treatments. Combining ulinastatin with thymosin-α1 also lowered death risk by about 35%. PUFA and monoclonal antibodies showed smaller but still meaningful reductions in mortality.
These therapies also helped patients leave the intensive care unit and hospital sooner. For example, ulinastatin plus thymosin-α1 shortened ICU stays by about three days. PUFA was linked to shorter hospital stays, and ulinastatin alone reduced the time on a ventilator.
Importantly, these treatments were linked to fewer serious side effects. However, the overall certainty of the evidence is low, meaning more high-quality studies are needed to confirm these benefits.