ReviewJuntendo medical journal2026
Endotoxin Activity Assay-guided Polymyxin B Hemoperfusion: From Failed Trials to Biological Enrichment.
Review in Juntendo medical journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Septic shock remains a leading cause of mortality despite advances in critical care. Polymyxin B hemoperfusion (PMX-HP) has long been proposed to improve outcomes by removing circulating endotoxin, yet randomized trials have yielded inconsistent results. Early enthusiasm from EUPHAS was followed by neutral findings in ABDO-MIX and EUPHRATES, highlighting the limitations of non-enriched trial designs. The latest evidence from the TIGRIS trial, a randomized controlled trial, provides important new insight. In patients with endotoxic septic shock, defined by an endotoxin activity assay (EAA) of 0.60-0.89 and high organ dysfunction, polymyxin B hemoadsorption was associated with a high posterior probability of mortality reduction, particularly at 90 days. This article critically appraises the rationale and limitations of EAA-guided PMX-HP in light of these updated data. While the findings support a biologically enriched strategy, important uncertainties remain regarding assay performance, feasibility, and generalizability. The integration of EAA with complementary biomarkers and clinical phenotypes is likely necessary to advance precision medicine in sepsis.
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