PT  - JOURNAL ARTICLE
AU  - Antoni Torres
AU  - Oriol Sibila
AU  - Miquel Ferrer
AU  - Rosario Mendendez
AU  - Josep Mensa
AU  - Albert Gabarrus
AU  - Jacobo Sellares
AU  - Marcos Restrepo
AU  - Antonio Anzueto
AU  - Nichael Niederman
AU  - Carlos Agusti
AU  - Eva Polverino
TI  - Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: A randomized clinical trial
AID  - 10.1183/13993003.congress-2015.OA3267
DP  - 2015 Sep 01
TA  - European Respiratory Journal
PG  - OA3267
VI  - 46
IP  - suppl 59
4099  - http://erj.ersjournals.com/content/46/suppl_59/OA3267.short
4100  - http://erj.ersjournals.com/content/46/suppl_59/OA3267.full
SO  - Eur Respir J2015 Sep 01; 46
AB  - Introduction: Treatment failure is associated with excessive inflammatory response and worse outcomes in patients with severe community-acquired pneumonia (CAP). However the anti-inflammatory role of corticosteroids in these patients remains controversial. We aimed to investigate effects of intravenous methylprednisolone (M-Pred) on treatment failure of severe CAP.Materials and methods: We conducted a multicenter, randomized, double-blind, placebo-controlled trial in severe CAP patients with inflammatory response (C-reactive protein >150 mg/L). Of 120 recruited patients 61 were assigned to receive 0·5 mg/kg of M-Pred, and 59 to receive placebo, BID for 5 days.Primary outcome was treatment failure (early and/or late).Results: Patients on M-Pred had less treatment failure compared to placebo (8 [13%] vs. 18 [31%], p=0·021; OR: 0·34, 95%CI 0·14 to 0·87, p=0·024) but similar in-hospital mortality (9[15%] vs. 6[10%]; p=0·37). The rate of hyperglycemia was similar in both groups (M-Pred 11 [18%],v placebo7 [12%], p=0·34).Conclusions: Among patients with severe CAP and high initial inflammatory response, the acute use of M-Pred compared with placebo decreased treatment failure. If replicated these findings would support use of corticosteroids as adjunctive treatment in this clinical population.Funding: SEPAR, SOCAP, FUCAP, SGR-2011, Fondo de Investigación 448 Sanitaria PI030113, IDIBAPS, CIBERES (CB06/06/0028).Trial registration: clinicaltrials.gov Identifier: NCT00908713.