Opinion: “High-Dose Immunosuppression to Prevent Death after Paraquat Self-Poisoning”- Under Estimation of a Significant Effect with Small Mortality Rate Reduction

A randomised double blinded clinical trial about high dose immunosuppression in Paraquat self-poisoning was published by Professor I. Gawaramanna et al. Before their research, it seems that a little overestimation might be present in the small previous non-randomised clinical trials. This new valuable work clarified the previous exaggerated favourable response to immunosuppression in paraquat self-poisoning; however, their analysis underestimated the favourable response to high dose immunosuppression. According to their results, high dose immunosuppression could decrease mortality considering serum paraquat level and effect time of immunosuppressive drugs but the opposite is concluded. They did not mention the impact of incomplete sample size on their results. Severe paraquat self-poisoning seems to be unresponsive to any treatment and these patients should be analyzed separately according to serum paraquat level. So after reanalysis of their results, the findings seem to be in favour of immunosuppression benefit in paraquat-self poisoning.