Many effective treatments are available to treat the pain of acute inflammation. Medicines called nonsteroidal anti-inflammatory drugs (for example, aspirin, Advil®, Aleve®) work by blocking the production of certain types of prostaglandins, which are molecules that can provoke an inflammatory reaction. All these medicines block a body enzyme called cyclooxygenase, or COX. In recent years, new types of COX-inhibiting drugs have become available: products such as Vioxx® and Celebrex® are effective treatments for the pain of arthritis and other conditions. Medicines that block certain types of cytokines are also widely used to treat the pain and inflammation of arthritis. Drugs such as Enbrel®, Remicade®, and Humira® are designed to soak up extra molecules of TNF, a powerful cytokine that stimulates inflammation in joints.

However, none of these anti-inflammatory treatments are effective in treating systemic inflammation. Despite the public health importance and a significant research investment in understanding the cell and molecular biology of the body-wide inflammation that underlies sepsis, few promising therapies have emerged. For example, previous efforts to treat sepsis by blocking endotoxin did not work, in part because scientists learned that sepsis can arise in the absence of infection by a Gram-negative species of bacteria. The failure to find effective treatments has frustrated doctors and patients; however, there is hope on the horizon.

A few new treatments do appear to reduce the death rate from sepsis. An approved drug known as Xigris™ blocks a molecule called protein C that is central to blood clotting. Researchers have hailed Xigris as the first effective treatment for sepsis, although it does not work in all patients. Other treatment strategies that have shown some benefit in managing systemic inflammation include optimizing the amount of oxygen in tissues by maintaining adequate fluid balance and transfusing blood, and tightly controlling blood sugar with insulin.