Vitamin B, Vitamin C and Corticosteroid Combo Fails To Help Organs Recover From Septic Shock: Study

The findings of a new study raise questions about the benefits of giving patients vitamin C, vitamin B1, and steroids to treat sepsis, indicating the treatments do not help improve conditions among those with the infection or help organs recover.

Patients who took the cocktail of vitamins and steroids did not have lower risk of death, kidney failure or other serious side effects, according to a report published this week in the Journal of the American Medical Association (JAMA).

Researchers with the Beth Israel Deaconess Medical Center in Boston hoped a simple regiment of ascorbic acid (vitamin C) infusions, thiamine (vitamin B1), and corticosteroids would improve outcomes for patients suffering from sepsis, which is often a deadly condition leading to severe organ failure and infection.

Sepsis is an infection of the bloodstream that typically stems from other serious infections like pneumonia, appendicitis, or infections of the blood. It can spread to other areas of the body and lead to organ failure. It can also cause decreased blood pressure, fever, and increased heart rate.

Sepsis is the leading cause of death among hospitalized patients. It causes 1 in 5 deaths worldwide and can lead to complications up to one year after the infections are treated.

The medical community had high hopes for treating patients with this combination of vitamins and steroids after a researcher reported he had success in 2017 treating a sepsis patient with this cocktail. Some doctors began using the combination quickly, based on the early results, though other doctors preferred to wait for further research confirming the treatment.

As a response, researchers launched the ACTS Randomized Clinical Trial. The study included more than 200 adults with septic shock who were given either a placebo or the combination of vitamin C, vitamin B1, and steroids in the randomized clinical trial from February 2018, to October 2019, at 14 medical centers in the United States.

Patients were treated for four days with the combination 1500 mg of vitamin C, 50 mg of hydrocortisone, and 100 mg of thiamine or were given a placebo every six hours. However, the data indicates there was no benefit to giving patients the vitamin and steroid cocktail to treat sepsis.

Patients were assessed based on change in their sequential organ failure assessment score (SOFA). SOFA scores were 4.7 in the vitamin/steroid group compared to 4.1 in the placebo group over the first 72 hours. There was no statistical difference in improvement.

Researchers also noted there was no statistical difference in the incidence of kidney failure or in 30-day death rates.

“This trial does not support the routine use of the combination of ascorbic acid, corticosteroids, and thiamine for organ protection in septic shock populations,” the researchers wrote.

Other research has focused on how to treat and prevent sepsis. One study indicated more strict hospital regulations helped to reduce sepsis rates. However, another study published in JAMA Network Open indicated most cases of the lethal infection are not preventable because they are linked to other underlying conditions.

The most common serious side effects from sepsis in the new study were hyperglycemia, hypernatremia, and new hospital-acquired infections.

Roughly 11 million people globally are infected with sepsis every year leading to an estimated 270,000 deaths. It is a lethal infection that can be difficult to treat with limited drug treatment options, even under the best conditions.