We need to improve our ability to define appropriate molecular targets for preclinical development and develop better methods to determine the clinical value of novel sepsis agents. Clinical trials must have realistic sample sizes and meaningful endpoints. Biomarker-driven studies should be considered to categorize specific "at risk" populations most likely to benefit from a new treatment. Innovations in clinical trial design such as parallel crossover design, alternative endpoints, or adaptive trials should be pursued to improve the outlook for future interventional trials in sepsis.
Konrad Neumann, Ulrike Grittner, Sophie K. Piper, André Rex, Oscar Flórez-Vargas, George Karystianis, Alice Schneider, Ian Wellwood, Bob Siegerink, John P A Ioannidis, Jonathan Kimmelman, Ulrich Dirnagl
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