2020 ACTS TRIAL Effect of ascorbic acid, corticosteroids, and thiamine on organ injury in septic shock Multicenter, randomized, blinded, placebo-controlled superiority trial M Objective: To determine whether the combination of ascorbic acid, corticosteroids, and thiamine attenuates organ injury in patients with septic shock. 205 patients Inclusion criteria: Patients ≥18 years of age with infection and received vasopressor because of sepsis Ascorbic acid + Hydrocortisone + Thiamine (n=101) Placebo group (n=99) PRIMARY OUTCOME Change in SOFA score 4.4 5.1 Diff -0.8; 95% CI, -1.7 to 0.2; P=0.12 SECONDARY OUTCOME 34.7 All-cause mortality at day 30 % 29.3 HR 1.3; 95% CI, 0.8 to 2.2; P = 0.26 Incidence of kidney failure % 31.7 Diff 0.03; 95% CI, -0.1 to 0.2; P = 0.58 27.3 Conclusion: In patients with septic shock, the combination of ascorbic acid, corticosteroids, and thiamine, compared with placebo, did not result in a statistically significant reduction in SOFA score during the first 72 hours after enrollment. Moskowitz et al. JAMA. 2020;324(7):642-650