What is the role of recombinant activated protein C in the management of sepsis?

During an episode of sepsis, systemic inflammatory response phenomenon triggers a series of procoagulant mechanisms. It has been suggested that the use of activated protein C could play a role in the management of this pathology, but there is no consensus. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified seven systematic reviews covering 35 primary studies addressing the question of this article, including six randomized trials. We extracted data, combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded activated protein C in sepsis probably does not decrease the mortality rate and increases the rate of hemorrhagic events.