Administration of an antibody to E-selectin in patients with septic shock
Friedman, G.; Jankowski, S.; Shahla, M.; Goldman, M.; Rose, R.M.; Kahn, R.J.; Vincent, J.L.
Critical Care Medicine 24(2): 229-233
1996
ISSN/ISBN: 0090-3493 PMID: 8605793 Document Number: 465912
Objectives: To determine the safety and pharmacokinetics of a murine monoclonal antibody to E-selectin in patients with newly developed septic shock. Design: Open-label, prospective, phase II pilot study with escalating doses of the antibody. Setting: Intensive care unit of a 900-bed university hospital. Patients: Nine patients who survived the first 24 hrs of septic shock. Interventions: In addition to standard therapy, an intravenous bolus of a murine monoclonal antibody to E-selectin, CY1787, was given at doses of 0.1 mg/kg (n = 3), 0.33 mg/kg (n = 3), and 1.0 mg/kg (n = 3). Measurements and Main Results: CY1787 was well tolerated in all patients. Signs of shock resolved in all patients, and organ failure entirely reversed in eight patients. All patients survived the 28-day follow-up. Administration of CY1787 was associated with an early and brisk increase in PaO-2/FIO-2, ratio (p lt .001), from 146 +- 38 mm Hg (19.5 +- 5.1 kPa) to 205 +- 45 mm Hg (27.3 +- 6.0 kPa) after 2 hrs, and 250 +- 58 mm Hg (33.3 +- 7.7 kPa) after 12 hrs. A dose-related effect of CY1787 was suggested by an earlier weaning from catecholamine therapy and a faster resolution of organ failure in the high-dose group. Development of antimouse antibodies was documented in eight patients. Conclusions: This pilot study indicates that this antibody to E-selectin appears to be safe and may represent a promising form of therapy in septic shock.