SynthesisCritical care medicine2013
Antitumor necrosis factor therapy is associated with improved survival in clinical sepsis trials: a meta-analysis.
Synthesis in Critical care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
58 citing papers in PubMed, 1 synthesis or guideline pooled it, 109 citations in OpenAlex.
- Tumour necrosis factor-alpha inhibitors decrease mortality in COVID-19: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- A nebulised antitumour necrosis factor receptor-1 domain antibody in patients at risk of postoperative lung injury: A randomised, placebo-controlled pilot study.European journal of anaesthesiology · 2020Trial
- Reverse-Engineered Lipid Nanoparticles Harness Protein Corona Formation for Cytokine Sequestration and Combination Immunomodulatory Therapy.Small (Weinheim an der Bergstrasse, Germany) · 2026Article
- Sarcopenia and sepsis fuel a self-perpetuating cycle of immunometabolism decline.Frontiers in immunology · 2026Review
- When hidradenitis suppurativa flares mimic sepsis: A case series of 6 hospitalized patients.JAAD case reports · 2025Article
- Molecular endotypes in sepsis: integration of multicohort transcriptomics based on RNA sequencing.Journal of intensive care · 2025Article
- Discrete and conserved inflammatory signatures drive thrombosis in different organs after Salmonella infection.Nature communications · 2025Article
- Emerging antimicrobial therapies for Gram-negative infections in human clinical use.npj antimicrobials and resistance · 2025Review
- A review of gut failure as a cause and consequence of critical illness.Critical care (London, England) · 2025Review
- Cytokines in sepsis: a critical review of the literature on systemic inflammation and multiple organ dysfunction.Frontiers in immunology · 2025Review
- Hemoadsorption improves kidney microcirculatory oxygenation and oxygen consumption, ameliorates tubular injury, and improves kidney function in a rat model of sepsis-induced AKI.Scientific reports · 2024Article
- Pyruvate Kinase M2 Nuclear Translocation Regulate Ferroptosis-Associated Acute Lung Injury in Cytokine Storm.Inflammation · 2024Article
- Enhancing sepsis biomarker development: key considerations from public and private perspectives.Critical care (London, England) · 2024Review
- Applications of peptides in nanosystems for diagnosing and managing bacterial sepsis.Journal of biomedical science · 2024Review
- Prediction of Subclinical and Clinical Multiple Organ Failure Dysfunction in Breast Cancer Patients-A Review Using AI Tools.Cancers · 2024Review
- ERS International Congress 2022: highlights from the Respiratory Intensive Care Assembly.ERJ open research · 2023Review
- Role of necroptosis in kidney health and disease.Nature reviews. Nephrology · 2023Review
- Exploring the perspective of patients with immune-mediated inflammatory diseases and care providers on the use of immunomodulatory drugs in infections: an interview study.Rheumatology advances in practice · 2023Article
- Immunotherapies against human bacterial and fungal infectious diseases: A review.Frontiers in medicine · 2023Review
- TLR7 Mediates Acute Respiratory Distress Syndrome in Sepsis by Sensing Extracellular miR-146a.American journal of respiratory cell and molecular biology · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectivesSepsis is a lethal syndrome annually affecting approximately 900,000 patients in the United States alone. Despite their benefit in rheumatoid disease, selective antitumor necrosis factor agents failed to improve outcome in early sepsis trials in the 1990s. However, data from additional sepsis trials testing these agents are now available. We therefore sought to determine the effect on survival of selective antitumor necrosis factor agents in randomized clinical sepsis trials.. DATA SOURCES: PubMed, Scopus, Embase, and Web of Science. STUDY SELECTION: Randomized human sepsis trials of selective antitumor necrosis factor agents reporting survival rates. DATA EXTRACTION: Two investigators independently collected relevant data on study characteristics, treatment interventions, and patients from each study. DATA SYNTHESIS: Antitumor necrosis factor agents in 15 sepsis trials (n=8,896 patients) meeting inclusion criteria had similar effects (I=0, p=0.84) and compared with controls (placebo in 14 trials or a lower dose in one trial) overall decreased the relative risk of death (95% CI) (0.93 [0.88-0.98], p=0.01). In subgroup analysis, tumor necrosis factor monoclonal antibodies (10 trials, n=6,818) alone produced a significant survival benefit (0.93 [0.87, 0.99], p=0.02) (I=0, p=0.83). Tumor necrosis factor polyclonal antibodies (two trials, n=151) and low-molecular-weight soluble receptor (two trials, n=1,786) had similar beneficial effects to antitumor necrosis factor agents overall (0.82 [0.49-1.37], p=0.45; 0.93 [0.81-1.08], p=0.33, respectively). The effect of tumor necrosis factor high-molecular-weight soluble receptor (one trial, n=141) was not significantly different from other agents but was on the side of harm (1.50 [0.86-2.61], p=0.16).
conclusionAntitumor necrosis factor agents produced a modest but significant decrease in the risk of dying with sepsis. Prior individual trials failed to demonstrate benefit, likely because they were underpowered. A definitive trial demonstrating the potential benefit of such agents might require 10,000 or more patients with sepsis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.