Prolonged higher dose methylprednisolone
Journal
The European respiratory journal
ISSN: 1399-3003
Titre abrégé: Eur Respir J
Pays: England
ID NLM: 8803460
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
01
08
2022
accepted:
23
10
2022
medline:
24
4
2023
pubmed:
11
11
2022
entrez:
10
11
2022
Statut:
epublish
Résumé
Dysregulated systemic inflammation is the primary driver of mortality in severe coronavirus disease 2019 (COVID-19) pneumonia. Current guidelines favour a 7-10-day course of any glucocorticoid equivalent to dexamethasone 6 mg daily. A comparative randomised controlled trial (RCT) with a higher dose and a longer duration of intervention was lacking. We conducted a multicentre, open-label RCT to investigate methylprednisolone 80 mg as a continuous daily infusion for 8 days followed by slow tapering 677 randomised patients were included. Findings are reported as methylprednisolone (n=337) Prolonged, higher dose methylprednisolone did not reduce mortality at 28 days compared with conventional dexamethasone in COVID-19 pneumonia.
Sections du résumé
BACKGROUND
Dysregulated systemic inflammation is the primary driver of mortality in severe coronavirus disease 2019 (COVID-19) pneumonia. Current guidelines favour a 7-10-day course of any glucocorticoid equivalent to dexamethasone 6 mg daily. A comparative randomised controlled trial (RCT) with a higher dose and a longer duration of intervention was lacking.
METHODS
We conducted a multicentre, open-label RCT to investigate methylprednisolone 80 mg as a continuous daily infusion for 8 days followed by slow tapering
RESULTS
677 randomised patients were included. Findings are reported as methylprednisolone (n=337)
CONCLUSION
Prolonged, higher dose methylprednisolone did not reduce mortality at 28 days compared with conventional dexamethasone in COVID-19 pneumonia.
Identifiants
pubmed: 36356972
pii: 13993003.01514-2022
doi: 10.1183/13993003.01514-2022
pmc: PMC9650195
pii:
doi:
Substances chimiques
Methylprednisolone
X4W7ZR7023
Dexamethasone
7S5I7G3JQL
Oxygen
S88TT14065
Banques de données
ClinicalTrials.gov
['NCT04636671']
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright ©The authors 2023.
Déclaration de conflit d'intérêts
Conflict of interest: F. Salton, P. Confalonieri, S. Centanni, M. Mondoni, N. Petrosillo, D. Lacedonia, A. Voza, N. Carpenè, M. Montico, N. Reccardini, G.U. Meduri, B. Ruaro and M. Confalonieri have no conflicts of interest to disclose. P. Bonfanti received personal fees from ViiV Healthcare, Gilead, Janssen, Merck and Pfizer, not related to this work. G. Lapadula received personal fees from ViiV Healthcare and Pfizer, not related to this work.
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