https://abs.twimg.com/emoji/v2/... draggable="false" alt="🚨" title="Polizeiautos mit drehendem Licht" aria-label="Emoji: Polizeiautos mit drehendem Licht">BIG NEWS: In January, the unpublished VICTAS trial of vitamin C in #sepsis was stopped after enrolling just 501 of a planned 2000

Now data on http://clinicaltrials.gov"> http://clinicaltrials.gov  shows why, and it doesn’t look good for #vitaminC. Is this the lasthttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🔩" title="Mutter und Schraube" aria-label="Emoji: Mutter und Schraube">inhttps://abs.twimg.com/emoji/v2/... draggable="false" alt="⚰️" title="Sarg" aria-label="Emoji: Sarg">of the ‘metabolic cure’?

A shorthttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🧵" title="Thread" aria-label="Emoji: Thread">
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I’ve been hopeful but more than a little skeptical about the https://abs.twimg.com/emoji/v2/... draggable="false" alt="🍹" title="Tropisches Getränk" aria-label="Emoji: Tropisches Getränk">https://abs.twimg.com/emoji/v2/... draggable="false" alt="🍋" title="Zitrone" aria-label="Emoji: Zitrone"> metabolic cocktail for sepsis (vitamin C + hydrocortisone + thiamine) since the original before/after case series.

I’ve followed this literature closely & have been waiting eagerly for the results of the RCTs.
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Thats’s why I was excited to see that VICTAS had posted results. https://bit.ly/3j3Iatl 

The">https://bit.ly/3j3Iatl&q... VICTAS trial is the largest (& arguably best) of the vitamin C RCTs: a placebo-controlled, Double-blind RCT done at 43 sites across the US. The 1° endpoint was vasopressor free days.
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The results are incomplete & we will need to wait for the actual publication to get the full picture.

But what we can see doesn’t look good:
* similar mortality rate in both arms
* more vasopressor free days in the control group
* some adverse events in the vitamin C arm
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Even with this limited data and some simple stats, we can see that there is no significant difference in all cause mortality:
- HAT 22.2% vs Placebo 24.1% (RR 0.92 95% CI 0.67 - 1.27; p = 0.67)

There also isn’t a difference in vasopressor free days:
- HAT 25 vs Placebo 26
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When we think about these results in the context of the other published studies it https://abs.twimg.com/emoji/v2/... draggable="false" alt="🎨" title="Farbpalette" aria-label="Emoji: Farbpalette">a consistenthttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🖼" title="Bilderrahmen mit Bild" aria-label="Emoji: Bilderrahmen mit Bild">:
- *not one* study has replicated the effect seen by Marik et al

See my updated Forrest Plot (full blog post soon): The more studies we do the smaller the overall effect.
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