The efficacy and safety of antithrombin and recombinant human thrombomodulin combination therapy in patients with severe sepsis and disseminated intravascular coagulation

PurposeRecombinant human thrombomodulin (rhTM) is often used concomitantly with antithrombin (AT) to treat disseminated intravascular coagulation (DIC). This observational study aimed to investigate the efficacy and safety of AT + rhTM combination therapy.Materials and methodsOne hundred twenty-nine patients with severe sepsis and DIC participated in this study. Of these, 78 patients were treated with AT + rhTM (AT + rhTM group) and 51 patients were treated with AT alone (AT group). We compared coagulation and inflammation markers, Sequential Organ Failure Assessment score, and DIC score at day 0 (baseline) and day 7 between the 2 groups. Bleeding events and 28-day mortality were also compared.ResultsPlatelet counts and D-dimer levels at day 7 significantly improved in the AT + rhTM group compared with the AT group, and 28-day mortality was significantly lower in the AT + rhTM group than in the AT group (AT + rhTM: 15.4% vs AT: 29.4%). During the study period, the incidence of bleeding complications was similar in both groups (AT + rhTM: 6.4% vs AT: 7.8%).ConclusionsCompared with AT monotherapy, combination therapy with AT and rhTM may be more effective in improving platelet counts and D-dimer levels, as well as reducing mortality, in patients with severe sepsis-associated DIC.