Biomarker Analysis for Combination Therapy of Vitamin C and Thiamine in Septic Shock: A Post-Hoc Study of the ATESS Trial

• Published in: Shock (Augusta, Ga.) Ga.), 2022-01, Vol.57 (1), p.81-87
• Main Authors: Park, Jong Eun, Jo, You Hwan, Hwang, Sung Yeon, Kim, Won Young, Ryoo, Seung Mok, Jang, Dong-Hyun, Kim, Taegyun, Kim, Youn-Jung, Kim, Seonwoo, Cho, Hyun, Lee, Gun Tak, Chung, Sung Phil, Choi, Sung-Hyuk, Shin, Tae Gun, Suh, Gil Joon
• Format: Article
• Language: English
• Subjects: Aged; Angiopoietin-2 - blood; Ascorbic Acid - therapeutic use; Biomarkers; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Interleukin-10 - blood; Interleukin-6 - blood; Male; Middle Aged; S100 Calcium Binding Protein beta Subunit - blood; Shock, Septic - blood; Shock, Septic - drug therapy; Shock, Septic - mortality; Thiamine - therapeutic use; Vitamins - therapeutic use
• ISSN: 1073-2322; 1540-0514
• DOI: 10.1097/SHK.0000000000001850

We evaluated the effects of vitamin C and thiamine administration on biomarkers in patients with septic shock. This was a post-hoc analysis of the Ascorbic Acid and Thiamine Effect in Septic Shock (ATESS) trial, a multicenter, double-blind, randomized controlled trial. Patients were randomized to either a treatment group (intravenous vitamin C and thiamine for 48 h) or a control group. Interleukin (IL)-6, IL-10, angiopoietin-II (AP2), and S100β were assessed at baseline and at 72 h. The primary outcomes were the biomarker levels at 72 h, and the secondary outcome was reduction rate. Forty-five patients were assigned to the treatment group and 52 were assigned to the control group. Baseline biomarker levels and at 72 h were not significantly different between the treatment and the placebo groups. The reduction rates were not significantly different between the two groups. These outcome variables showed fair diagnostic accuracy for predicting 28-day mortality according to the area under the receiver operating characteristic curve. Vitamin C and thiamine administration during the early phase of septic shock did not significantly change prognostic biomarker levels of IL-6, IL-10, AP2, and S100β. NCT, ClinicalTrials.gov NCT03756220, ATESS. Registered 28 November 2018, https://clinicaltrials.gov/ct2/show/NCT03756220.