Efficacy of early sivelestat administration on acute lung injury and acute respiratory distress syndrome
- 18 December 2016
- journal article
- research article
- Published by Wiley in Respirology
- Vol. 22 (4), 708-713
- https://doi.org/10.1111/resp.12969
Abstract
The efficacy of sivelestat, a neutrophil elastase inhibitor, for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) remains controversial. We investigated the role of sivelestat in ALI/ARDS patients on mortality as an end point between the sivelestat group and the non-sivelestat group within 7 days of admission. This study was performed using the Japanese nationwide administrative database (Diagnostic Procedure Combination; DPC) in 2012. We employed the propensity score weighting method with a Cox proportional hazards model to compare the mortality between the sivelestat group and the non-sivelestat group. A total of 4276 patients were eligible for this study; 1997 patients were treated with sivelestat and 2279 patients did not receive sivelestat within 7 days of admission. After adjusting for confounds, the mortality within 3 months was significantly lower in the sivelestat group compared with the non-sivelestat group (weighted hazard ratio: 0.83; 95% CI: 0.75–0.93; P < 0.002). Multiple regression analysis revealed that younger age, absence of cancer, no need for haemodialysis and no use of high-dose methylprednisolone were significantly correlated with treatment success (survive). These results of this retrospective and observational study suggest that administration of sivelestat within 7 days of admission may improve the prognosis of patients with ALI/ARDS. To our knowledge, this is the largest study to evaluate the efficacy of sivelestat on ALI/ARDS.Keywords
This publication has 26 references indexed in Scilit:
- Usefulness of a selective neutrophil elastase inhibitor, sivelestat, in acute lung injury patients with sepsisDrug Design, Development and Therapy, 2013
- Continuous regional arterial infusion for acute pancreatitis: a propensity score analysis using a nationwide administrative databaseCritical Care, 2013
- Clinical evaluation of sivelestat for acute lung injury/acute respiratory distress syndrome following surgery for abdominal sepsisDrug Design, Development and Therapy, 2012
- Variation in cancer surgical outcomes associated with physician and nurse staffing: a retrospective observational study using the Japanese Diagnosis Procedure Combination DatabaseBMC Health Services Research, 2012
- Reevaluation of the efficacy and safety of the neutrophil elastase inhibitor, Sivelestat, for the treatment of acute lung injury associated with systemic inflammatory response syndrome; a phase IV studyPulmonary Pharmacology & Therapeutics, 2011
- Has Mortality from Acute Respiratory Distress Syndrome Decreased over Time?American Journal of Respiratory and Critical Care Medicine, 2009
- Do glucocorticoids decrease mortality in acute respiratory distress syndrome? A meta‐analysisRespirology, 2007
- PRETREATMENT OF SIVELESTAT SODIUM HYDRATE IMPROVES THE LUNG MICROCIRCULATION AND ALVEOLAR DAMAGE IN LIPOPOLYSACCHARIDE-INDUCED ACUTE LUNG INFLAMMATION IN HAMSTERSShock, 2006
- Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress SyndromeNew England Journal of Medicine, 2000
- ONO-5046, a novel inhibitor of human neutrophil elastaseBiochemical and Biophysical Research Communications, 1991