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Matsuda, Naoyuki Department of Emergency & Critical Care Medicine, Nagoya University Graduate School of Medicine
Nishida, Osamu Department of Anesthesiology & Critical Care Medicine, Fujita Health University School of Medicine
Taniguchi, Takumi Department of Anesthesiology & Intensive Care Medicine, Kanazawa University
Okajima, Masaki Intensive Care Unit, Kanazawa University Hospital
Morimatsu, Hiroshi Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons researchmap
Ogura, Hiroshi Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine
Yamada, Yoshitsugu Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital
Nagano, Tetsuji Clinical Development Planning, Ono Pharmaceutical Co., Ltd.
Ichikawa, Akira Clinical Development Planning, Ono Pharmaceutical Co., Ltd.
Kakihana, Yasuyuki Department of Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
J-Land 3S Study Group
Background The J-Land 3S trial demonstrated that landiolol is effective and tolerated for treating sepsis-related tachyarrhythmias. Patient characteristics (e.g. baseline heart rate [HR], type of tachyarrhythmia, and concomitant disorders) may impact the outcomes of landiolol therapy. We performed subanalyses of J-Land 3S to evaluate the impact of patient characteristics on the efficacy and safety of landiolol for treating sepsis-related tachyarrhythmia. Methods Patients (≥20 years old; N = 151) hospitalised with sepsis at 54 participating hospitals in Japan with HR ≥100 beats/min for ≥10 min accompanied by diagnosis of tachyarrhythmia were randomised 1:1 to conventional sepsis therapy alone (control group) or conventional sepsis therapy plus landiolol (landiolol group). The efficacy and safety of landiolol were assessed in prespecified analyses of patients divided into subgroups by baseline characteristics and in post hoc, multivariate analyses with adjustment for age and HR at baseline. Findings The percentage of patients with HR of 60–94 beats/min at 24 h after randomisation (primary endpoint) was greater in the landiolol group in most subgroups in univariate unadjusted analyses and in multivariate logistic regression. The incidence of new-onset arrhythmia by 168 h and mortality by 28 days were also lower in the landiolol group in most subgroups in univariate and multivariate Cox proportional hazards models. No subgroups showed a markedly higher incidence of adverse events in univariate or multivariate logistic regression analyses.
Ultra-short-acting β1-selective antagonist
© 2020 The Authors.