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Trotz jahrzehntelanger Forschung existiert bis heute kaum Evidenz f\u00fcr kausale Therapieans\u00e4tze gegen diese Wirtsantwort. Die Diskrepanz zwischen stetig wachsendem biologischen Verst\u00e4ndnis und begrenztem klinischen Fortschritt wird h\u00e4ufig als \u201etranslational gap\u201c bezeichnet. Randomisierte Studiendesigns waren zum einen auf heterogene Patientenkollektive fokussiert und nutzten zum anderen die Mortalit\u00e4t als prim\u00e4ren Endpunkt. Dadurch besteht die Gefahr, dass potenziell wirksame Interventionen in biologisch unterschiedlichen Patientengruppen verw\u00e4ssert werden und potenziell relevante Effekte statistisch nicht erkennbar sind. Die F\u00fclle an negativen Sepsisstudien hat nicht nur zu einer Art Fatigue der Wissenschaftler, sondern auch zu einer Angst vor finanziellem Schaden f\u00fcr die forschende Industrie gef\u00fchrt. Neuere Studien deuten jedoch darauf hin, dass pr\u00e4zisionsmedizinische Ans\u00e4tze einen Ausweg aus dieser Situation bieten k\u00f6nnten. Die aktuellen Untersuchungen ANDROMEDA-SHOCK\u20112, ImmunoSep und Tigris nutzen physiologische oder immunologische Ph\u00e4notypen zur Patientenselektion und kombinieren diese mit innovativen Endpunkten und modernen statistischen Methoden. Gemeinsam zeigen sie, dass eine st\u00e4rkere Ausrichtung an der zugrunde liegenden Pathophysiologie klinisch relevante Vorteile sichtbar machen kann, die in klassischen Studiendesigns verborgen bleiben. Diese Entwicklungen markieren einen grundlegenden Wandel in der Sepsisforschung: weg von universellen Therapiekonzepten, hin zu individualisierten, biologisch begr\u00fcndeten und adaptiven Behandlungsstrategien.<\/jats:p>","DOI":"10.1007\/s00063-026-01495-6","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T14:25:29Z","timestamp":1789482329000},"page":"550-556","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Personalisierte Sepsistherapie und moderne Studiendesigns","Personalized sepsis therapy and modern trial designs"],"prefix":"10.1007","volume":"121","author":[{"given":"Sascha","family":"David","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Erlebach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alix","family":"Buhlmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"issue":"6","key":"1495_CR1","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1038\/s41591-022-01843-x","volume":"28","author":"DM Maslove","year":"2022","unstructured":"Maslove\u00a0DM, Tang\u00a0B, Shankar-Hari\u00a0M, Lawler\u00a0PR, Angus\u00a0DC, Baillie\u00a0JK et\u00a0al (2022) Redefining critical illness. 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F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}}]}}