Combining high suPAR with qSOFA 1 can help identify septic patients who will benefit from early treatment
A newly published randomized controlled trial included septic patients with qSOFA = 1 and high suPAR to be injected with either a placebo (saline water) or antibiotics. The trial showed that suPAR can identify septic patients who will benefit from early treatment (1).?
Sepsis, a life-threatening condition triggered by the body's response to infection, poses a significant medical challenge. In the emergency department, a common issue arises as many patients present signs of sepsis (qSOFA = 1). Some of these patients may progress to severe sepsis, and early intervention can avert this from occurring. However, administering all patients with a qSOFA of 1, antibiotics would contribute to the increasing level of antimicrobial resistance.?
We know from a previous study that a suPAR level of 12 ng/mL or more acts as an independent prediction indicator of death within the patient's first 28 days of hospitalization (2,3). In the SUPERIOR trial, the goal was to discover the answer to the question: How can we identify septic patients in need of early treatment? The trial investigated patients of both genders over the age of 18, with one point of qSOFA and a suPAR blood level of 12 or more, to find the ones who could potentially benefit from early treatment for sepsis.?
The SUPERIOR trial concluded with the successful achievement of its primary objective. Measuring suPAR levels in patients admitted to the emergency department with a qSOFA score of one highlights the danger of unfavorable outcomes and guides the decision to provide early treatment for sepsis. Furthermore, the trial effectively justified four other vital endpoints, including preventing a ≥ 2-point increase in admission in SOFA occurring within the initial 24 hours, increasing infection resolution, decreasing the time to infection resolution, and providing validation for the prognostic performance of combining qSOFA and suPAR.?
The SUPERIOR trial documents that healthcare professionals can now also use suPAR to identify and treat septic patients early who otherwise would be at high risk of a negative outcome
?suPAR is already used in hospitals to triage patients, supporting clinical decision-making across disease areas.?
This trial proves that healthcare professionals already today can use suPAR to identify patients who have some indication of sepsis (qSOFA=1) and a high risk of progressing to severe sepsis, which allows for early treatment that may prevent this progression.?
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Reference:?
1. Adami, M.E., et.al. (2024) qSOFA combined with suPAR for early risk detection and guidance of antibiotic treatment in the emergency department: a randomized controlled trial. Crit Care 28, 42.
2. Velissaris, D., et.al. (2020). Prognostic role of soluble urokinase plasminogen activator receptor at the emergency department: a position paper by the Hellenic sepsis study group. Infectious diseases and therapy, 9, 407-416.