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The median number of non-ICU hospital days was 16 days (IQR, 9-28 days) among survivors vs 7 days (IQR 3-14 days) among non-survivors Authors’ Conclusions Levocarnitine did not meaningfully reduce organ failure at 48 hours in patients with septic shock Strengths Pharmacists were the only individuals not masked to treatment, and they had no study-related contact with the investigators or participants Levocarnitine or placebo was prepared in identical polypropylene infusion bags with labels that included the study identification number, patient name, medical record number, and infusion rate Demonstrates the potential benefit of a Bayesian adaptive randomization design by preferentially allocating patients toward the most efficacious high dose, rather than the lower doses, whilst maintaining allocation to placebo patients Weaknesses A change in the SOFA score may not represent the best surrogate end point for primary outcome measurement in sepsis trials Whilst adequately powered, only 106 patients were enrolled at the highest levocarnitine dose

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For patient treatment, approved GLP-1 or GIP/GLP-1 medications remain the practical comparison point until regulators decide whether to approve cagrilintide-containing products