Effects of different dosages/frequency of Xuebijing injection (a Chinese patent) for sepsis: a network meta-analysis of randomized controlled trials

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Objective: Xuebijing injection (XBJ) has been widely recognized in the treatment of sepsis, however, inadequate information regarding XBJ's optimal dosage and frequency suffice. We aimed to assess the effectiveness of various doses and administration frequencies in patients with sepsis using a network meta-analysis (NMA) to offer therapeutic prescription guidance. Methods: We examined eight databases for 1,765 randomized controlled trials published before July 2024, organized the literature using NoteExpress software and extracted data using Microsoft Excel software. The literature's quality was assessed using the risk of bias evaluation approach endorsed by the Cochrane Collaboration. The analysis was conducted by NMA inside a frequency-based framework. Results: Forty-three qualifying studies were included in the analysis, including 5,818 participants. Regarding the enhancement of 28-day mortality, 50 Milliliter (ml)-tie in die (tid) exhibited optimal efficacy, 100 ml-tid demonstrated superior efficacy in ameliorating APACHE II scores, 50 ml-bis in die (bid) proved more effective in enhancing the activated partial thromboplastin time (APTT), while 100 ml-quaque die (qd) significantly improved C-reactive protein (CRP) levels. Additional findings are displayed in net league tables, forest plots, and funnel plot. Conclusions: A daily dose of 100 ml of XBJ was associated with improvement in APTT and CRP levels in patients with sepsis, a daily dose of 150 ml may decrease 28-day mortality; while XBJ with a single-day dose of 300 ml is more effective at improving the APACHE II score, higher dosages correlated with improved prognosis in these patients compared to other doses.

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