Takashi Kido1,2, Keiji Muramatsu3, Kazuhiro Yatera1, Takeshi Asakawa4, Hiroki Otsubo2, Tatsuhiko Kubo3, Yoshihisa Fujino3, Shinya Matsuda3, Toshihiko Mayumi2, Hiroshi Mukae1. 1. Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan. 2. Department of Emergency Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan. 3. Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Japan. 4. Department of Information Systems Center, University of Occupational and Environmental Health, Kitakyushu, Japan.
Abstract
BACKGROUND AND OBJECTIVE: The efficacy of sivelestat, a neutrophil elastase inhibitor, for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) remains controversial. We investigated the role of sivelestat in ALI/ARDS patients on mortality as an end point between the sivelestat group and the non-sivelestat group within 7 days of admission. METHODS: This study was performed using the Japanese nationwide administrative database (Diagnostic Procedure Combination; DPC) in 2012. We employed the propensity score weighting method with a Cox proportional hazards model to compare the mortality between the sivelestat group and the non-sivelestat group. RESULTS: A total of 4276 patients were eligible for this study; 1997 patients were treated with sivelestat and 2279 patients did not receive sivelestat within 7 days of admission. After adjusting for confounds, the mortality within 3 months was significantly lower in the sivelestat group compared with the non-sivelestat group (weighted hazard ratio: 0.83; 95% CI: 0.75-0.93; P < 0.002). Multiple regression analysis revealed that younger age, absence of cancer, no need for haemodialysis and no use of high-dose methylprednisolone were significantly correlated with treatment success (survive). CONCLUSION: These results of this retrospective and observational study suggest that administration of sivelestat within 7 days of admission may improve the prognosis of patients with ALI/ARDS. To our knowledge, this is the largest study to evaluate the efficacy of sivelestat on ALI/ARDS.
BACKGROUND AND OBJECTIVE: The efficacy of sivelestat, a neutrophil elastase inhibitor, for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) remains controversial. We investigated the role of sivelestat in ALI/ARDSpatients on mortality as an end point between the sivelestat group and the non-sivelestat group within 7 days of admission. METHODS: This study was performed using the Japanese nationwide administrative database (Diagnostic Procedure Combination; DPC) in 2012. We employed the propensity score weighting method with a Cox proportional hazards model to compare the mortality between the sivelestat group and the non-sivelestat group. RESULTS: A total of 4276 patients were eligible for this study; 1997 patients were treated with sivelestat and 2279 patients did not receive sivelestat within 7 days of admission. After adjusting for confounds, the mortality within 3 months was significantly lower in the sivelestat group compared with the non-sivelestat group (weighted hazard ratio: 0.83; 95% CI: 0.75-0.93; P < 0.002). Multiple regression analysis revealed that younger age, absence of cancer, no need for haemodialysis and no use of high-dose methylprednisolone were significantly correlated with treatment success (survive). CONCLUSION: These results of this retrospective and observational study suggest that administration of sivelestat within 7 days of admission may improve the prognosis of patients with ALI/ARDS. To our knowledge, this is the largest study to evaluate the efficacy of sivelestat on ALI/ARDS.
Authors: Roni F Rayes; Jack G Mouhanna; Ioana Nicolau; France Bourdeau; Betty Giannias; Simon Rousseau; Daniela Quail; Logan Walsh; Veena Sangwan; Nicholas Bertos; Jonathan Cools-Lartigue; Lorenzo E Ferri; Jonathan D Spicer Journal: JCI Insight Date: 2019-07-25
Authors: Lukas Kurt Postl; Viktoria Bogner; Martijn van Griensven; Marc Beirer; Karl Georg Kanz; Christoph Egginger; Peter Biberthaler; Chlodwig Kirchhoff Journal: Eur J Med Res Date: 2018-09-15 Impact factor: 2.175
Authors: Ana Amaral; Carina Fernandes; Maria Rosa Rebordão; Anna Szóstek-Mioduchowska; Karolina Lukasik; Barbara Gawronska-Kozak; Luís Telo da Gama; Dariusz J Skarzynski; Graça Ferreira-Dias Journal: Animals (Basel) Date: 2020-05-16 Impact factor: 2.752