RT Journal Article SR Electronic T1 Efficacy of Ascorbic Acid, Thiamine, and Hydrocortisone Combination Therapy: Meta-analysis of Randomized Controlled Trials JF In Vivo JO In Vivo FD International Institute of Anticancer Research SP 1236 OP 1245 DO 10.21873/invivo.13200 VO 37 IS 3 A1 TAKAHIRO KATO A1 TOMOHIRO MIZUNO A1 MASANORI NAKANISHI A1 JEANNIE K. LEE A1 SHIGEKI YAMADA A1 NAOTAKE TSUBOI A1 KAZUO TAKAHASHI YR 2023 UL http://iv.iiarjournals.org/content/37/3/1236.abstract AB Background/Aim: Sepsis is a life-threatening biological condition that induces systemic tissue and organ dysfunction and confers a high mortality risk. Although the use of hydrocortisone in combination with ascorbic acid and thiamine (HAT therapy) significantly reduced mortality from sepsis or septic shock in a previous study, it did not improve mortality in subsequent randomized controlled trials (RCTs). Therefore, no definitive conclusion has been established on the benefits of HAT therapy for sepsis or septic shock. We performed a meta-analysis to assess the treatment outcomes of HAT therapy in patients with sepsis or septic shock. Patients and Methods: We searched databases (PubMed/MEDLINE, Embase, Scopus and Cochrane Library) for RCTs using the terms “ascorbic acid”, “thiamine”, “sepsis”, “septic shock”, and “RCT”. The primary outcome of this meta-analysis was the mortality rate, and the secondary outcomes were the incidence of new-onset acute renal injury (AKI), intensive care unit (ICU) length of stay (ICU-LOS), change in the Sequential Organ Failure Assessment (SOFA) score within 72 hours, and duration of vasopressor use. Results: Nine RCTs were identified and included in the outcome evaluation. HAT therapy did not improve the 28-day and ICU mortality, new-onset AKI, ICU-LOS, or SOFA scores. However, HAT therapy significantly shortened the duration of vasopressor use. Conclusion: HAT therapy did not improve mortality, the SOFA score, renal injury, or ICU-LOS. Further studies are needed to confirm whether it shortens the duration of vasopressor use.