Angiotensin II Helps Patients With Catecholamine-Resistant Distributive Shock Achieve Target Mean Arterial Pressure

March 26, 2019

By Charles Grey

BRUSSELS, Belgium -- March 25, 2019 -- In patients with catecholamine-resistant distributive shock and baseline mean arterial pressure (MAP)

Results of the phase 3 Treatment of High-Output Shock (ATHOS-3) trial, presented here at the 39th International Symposium on Intensive Care and Emergency Medicine (ISICEM), showed that 54% of patients with a baseline MAP

In addition, patients treated with angiotensin II were less likely to need an increase in norepinephrine equivalent dose (24.0% vs 67.3%; P≤ .0001).

The findings are important because when fluid resuscitation fails to improve MAP, patients with shock are treated with increasing doses of vasopressors, which in turn increases the risk of potentially fatal cardiac adverse events, explained to Lui G. Forni, PhD, Royal Surrey County Hospital, Guildford, United Kingdom, and colleagues.

For the study, patients with a baseline MAP

The most commonly reported treatment-emergent adverse events among patients receiving angiotensin II and placebo were septic shock (19.2% vs 8.0%), anaemia (15.4% vs 8.0%), multi-organ failure (15.4% vs 24.0%), and atrial fibrillation (11.5% vs 12.0%). There were 2 discontinuations in the angiotensin II arm due to drug-related adverse events.

Funding for this study was provided by La Jolla Pharmaceutical Company.

[Presentation title: Achievement of an International Consensus Target Mean Arterial Pressure Following Initiation of Angiotensin II in Patients With Catecholamine-Resistant Distributive Shock]