Drotrecogin alfa (activated) in severe sepsis

Background: In April 2003 and March 2007 reports were developed by the Technology Assessment Unit (TAU) of the McGill University Health Centre (MUHC) on the use of drotrecogin alfa (activated) (DrotAA) for the treatment of severe sepsis. [...] The ADDRESS RCT, published in 2005, included less severe patients and found a hospital mortality of 20.6% in the placebo group and 20.5% in the DrotAA group (p=0.98), and 28-day mortality rates of 17% in the placebo group and 18.5% in the DrotAA group (p=0.34) (7). [...] The Technology Assessment Unit (TAU) of the McGill University Health Centre evaluated the use of DrotAA for the treatment of severe sepsis in 2003(7) and again in 2007 (6). [...] The criteria for the comparison groups used in the outcome analysis are summarised in Table 2. The majority of studies (11, 73.3%). [...] Three(12-14) of the studies concluded that DrotAA lowered the risk of mortality and improved health outcomes in patients with severe sepsis.