IL-1 receptor antagonist in sepsis: new findings with old data?

In a recent issue of Critical Care Medicine, Shakoory et al. reported the potential benefits of IL-1 receptor antagonist (IL-1 RA, anakinra) administration in the treatment of severe sepsis and septic shock when associated with hepatic dysfunction and coagulopathy (1). This study is an ancillary sub-analysis of a negative randomized clinical trial (RCT), which evaluated the effect of IL-1 RA in the larger population and published almost two decades ago (2).