29 d mortality: Placebo 20%, low-dose 15%, high-dose 27% (NS). VFDs: Low-dose 19.7, high-dose 17.3, placebo 18.3 (NS). SOFA score: Similar improvement across groups. Infection relapse and ICU/organ-failure-free days: NS.Safety: TNF-α significantly reduced (p < 0.001); no effect on IL-6/IL-8; AEs similar across groups; no safety signals; no subgroup showed clear benefit. This evidence concerns the gene IL6 and infection.