A double-blind placebo-controlled study of an infusion of lexipafant (platelet-activating factor receptor antagonist) in patients with severe sepsis

Platelet-activating factor (PAF) is a potent endogenous proinflammatory med iator implicated in the pathogenesis of septic shock A double-blind randomi zed placebo-controlled trial of an intravenous PAF receptor antagonist (lex ipafant) was conducted with 131 adult Thai patients with suspected severe s epsis (66 of whom had positive blood cultures), Detailed serial clinical, b iochemical, and cytokine measurements were performed. Lexipafant treatment was well tolerated. The 28-day mortality in the lexipafant group (61.4%) wa s similar to that in the placebo group (62.6%). There was also no evidence that lexipafant affected clinical or biochemical measures of disease severi ty or the profile of sequentially measured plasma cytokine levels. PAF may not have an important role in the pathogenesis of severe sepsis.