The ImmunoSep trial is one of the most ambitious attempts yet to personalise treatment in sepsis. This international, multicentre, double-blind, placebo-controlled study recruited 280 patients and stratified them into two distinct immune endotypes: those with macrophage activation-like syndrome (MALS), representing hyperinflammation, and those with immunoparalysis, representing immune suppression. Patients were then randomised to receive either anakinra, an interleukin-1 receptor antagonist for hyperinflammation, or interferon-gamma for immunoparalysis, alongside standard care. The primary aim was a reduction in organ dysfunction, measured by improvement in SOFA score by day 9.

Conducted across 26 sites in Europe, ImmunoSep is not powered for mortality but is designed to test whether a precision, immune-endotype-guided approach can reduce organ failure in sepsis, while also generating deep biomarker and -omics insights. Recruitment has been completed, and its results—highly anticipated—promise to challenge the traditional one-size-fits-all model of sepsis management.

The results will be presented by Evangelos Giamarellos at CCR Down Under 2025, where the trial’s potential to shape the future of personalised immunotherapy in critical care will take centre stage.

Michael Reade will present the CLIP II trial results at CCR Down Under 2025.

CLIP II is a phase III, multicentre, blinded, randomized non-inferiority trial comparing cryopreserved platelets versus conventional liquid-stored platelets for treating surgical bleeding, especially in high-risk adult cardiac surgery patients.

Cryopreservation (-80°C, with DMSO) can extend platelet shelf-life from just 5–7 days to up to two years, offering potential logistical advantages for smaller, rural, or military hospitals where liquid platelets are hard to maintain.

Approximately 808 patients will be enrolled across Australia and New Zealand (11-12 hospitals in Australia, 5 in NZ), with up to three units of study platelets given if a surgeon deems platelet transfusion necessary.

The primary endpoint is blood loss via surgical drains during the first 24 hours after ICU admission post-surgery; secondary endpoints include safety, transfusion needs, cost, ICU/hospital stay, and mortality.

If cryopreserved platelets are shown to be non-inferior to liquid platelets, this could enable a major shift in blood service practice—improving access, reducing waste, and enhancing preparedness in settings that currently struggle with platelet supply.