6/28/23, 10:01 PM EUPHRATES Pathway Feedback Search Clinical Topics Home Studies EUPHRATES EUPHRATES Disease Sepsis and septic shock Trial question What is the effect of targeted polymyxin B hemoperfusion among patients with septic shock and high endotoxin activity? Study design Multi-center Double blinded RCT Population Characteristics of study participants 39.0% female N = 450 61.0% male 450 patients (177 female, 273 male) Inclusion criteria: adult critically ill patients with septic shock and an endotoxin activity assay level > 0.60 Key exclusion criteria: limits in treatment that prohibited further escalation in the intensity or scope of organ support or initiation of RRT or a terminal disease state precluding short-term survival Interventions N=224 polymyxin B hemoperfusion (2 hemoperfusion treatments within 24 hours with a target duration of 90-120 minutes plus standard therapy) N=226 sham hemoperfusion (recirculation of 0.9% saline for 2 hours to simulate hemoperfusion plus conventional medical therapy) Primary outcome https://web.pathway.md/studies/recbwB3DJbs1C3kHL 1/2 6/28/23, 10:02 PM EUPHRATES Pathway Death at day 28 among all participants and among participants with multiple organ dysfunction score > 9 37.7 % 37.7 34.5 28.3 % 18.9 % 9.4 % No significant difference 0.0 % Polymyxin B hemoperfusion Sham hemoperfusion No significant difference in death at day 28 among all participants and among participants with multiple organ dysfunction score > 9 (37.7% vs. 34.5%; RR 1.09, 95% CI 0.85 to 1.39) Secondary outcomes No significant difference in change in multiple organ dysfunction score for all participants (-2.2 vs. -1.6; AD -0.48, 95% CI -1.1 to 0.14) Significant increase in change in mean arterial pressure (9.4 mmHg vs. 4.1 mmHg; AD 5.5 mmHg, 95% CI 2.5 to 8.6) No significant difference in change in serum creatinine (AD 0.18 mg/dL, 95% CI -0.3 to 0.7) Safety outcomes No significant difference in serious adverse events including worsening of sepsis and septic shock. Significant difference in cardiac arrest/cardio-respiratory arrest (3.8% vs. 9.0%). Conclusion In adult critically ill patients with septic shock and an endotoxin activity assay level > 0.60, polymyxin B hemoperfusion was not superior to sham hemoperfusion with respect to death at day 28 among all participants and among participants with multiple organ dysfunction score > 9. Reference R Phillip Dellinger, Sean M Bagshaw, Massimo Antonelli et al. Effect of Targeted Polymyxin B Hemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level: The EUPHRATES Randomized Clinical Trial. JAMA. 2018 Oct 9;320(14):1455-1463. Open reference URL https://web.pathway.md/studies/recbwB3DJbs1C3kHL 2/2