HA-1A in septic patients with ARDS: Results from the pivotal trial

Objective: To evaluate the effects of HA-1A, a human monoclonal antiendotoxin antibody, in septic patients with ARDS. Design: Substudy of a multicenter, double-blinded, placebo-controlled trial of HA-1A in septic patients. Patients: 63 septic patients with ARDS at the time of study entry. Intervention: A single intravenous injection of HA-1A (100 mg) or placebo. Results: A quantitative radiographic score, the PaO₂/FIO₂ ratio and an index of the severity of ARDS did not show a significant difference between the treatment and placebo groups at 3, 5 and 7 days after treatment. The duration of endotracheal intubation did not differ between the two groups. 15 of 30 HA-1A treated patients (50%) and 23 of 33 placebo-treated patients (69.7%) died within 28 days. The daily mortality was always lower in the HA-1A group, but this difference was not statistically significant at 28 days. The 28-day survival curves for the two treatment groups adjusted by covariate analysis were not significantly different (p=0.07). Using logistic regression, a significant independent effect of HA-1A treatment was detected upon the early survival rate at 7 days (p=0.03) but not at 14 and 28 days. Conclusion: A single injection of HA-1A in septic patients with ARDS did not reverse acute respiratory failure or improve long-term survival.