Key result
Angiotensin II is a viable and effective vasopressor for increasing blood pressure in patients with vasodilatory shock, though current high-quality evidence is limited to two randomized controlled trials.
Why the study?
Following favorable trial data and FDA approval of synthetic Angiotensin II for vasodilatory shock, the authors sought to summarize the current status of clinical research on its therapeutic use in shock.
Does angiotensin II improve blood pressure and reduce catecholamine requirements in patients with shock?
Does angiotensin II improve blood pressure and reduce catecholamine requirements in patients with shock?
Angiotensin II is a viable and effective vasopressor for increasing blood pressure in patients with vasodilatory shock, particularly as an add-on therapy when standard catecholamines are insufficient.
May support use in refractory vasodilatory shock; leaves open optimal integration into practice pending larger RCTs.
Angiotensin II is an octapeptide with potent vasoconstrictor activities. The recent publication of favorable data from ATHOS-3 trial in 2017 was followed by FDA priority review approval of GIAPREZA (LJPC-501) for management of hypotension in states of vasodilatory shock. Aiming to summarize the current status of clinical research on the therapeutic use of Angiotensin II in patients with shock, we searched for published and ongoing clinical trials, and reviewed the cornerstone research articles on the topic. It appears that the existing research on clinical use of Angiotensin II is rather scarce, however, with the recent approval under priority review, a boost in clinical research is highly anticipated, in order to provide further insight into the potential implications of the synthetic octapeptide in various refractory hypotensive states.
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A 2022 study conducted a review in Shock (septic and other vasodilatory shock). Angiotensin II vs. Placebo or alternative vasopressors was evaluated. Angiotensin II is a viable and effective vasopressor for increasing blood pressure in patients with vasodilatory shock, though current high-quality evidence is limited to two randomized controlled trials.
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