Clinical Impact of Recombinant Soluble Thrombomodulin for Disseminated Intravascular Coagulation Associated with Severe Acute Cholangitis

Recently, recombinant human soluble thrombomodulin (rTM) has been developed as a new drug for disseminated intravascular coagulation (DIC). This study aims to evaluate the clinical benefit of rTM in patients with sepsis-induced DIC caused by acute cholangitis who underwent biliary drainage. Patients were divided into two groups: the rTM therapy group and the non-rTM therapy group. The primary outcome was the DIC resolution rate at 7 days, and the secondary outcome was 28-day mortality rate. 35 patients were treated by rTM, and 36 patients were treated without rTM for DIC. The rate of resolution of DIC at day 7 was significantly higher in the rTM group than in the non-rTM group [82.9% vs 55.6%, p=0.0012]. Compared with the non-rTM group, the 28-day survival rate of the r-TM group was significantly higher [rTM vs non-rTM 91.4% vs 69.4%, p=0.014). According to multivariate analysis, non-rTM (HR 2.681) and CRP (HR 2.370) were factors related to decreased survival. rTM treatment may have a positive impact on improving DIC and survival rates in patients with severe acute cholangitis.