RT info:eu-repo/semantics/article
T1 Effect of intravenous pulses of methylprednisolone 250 mg versus dexamethasone 6 mg in hospitalised adults with severe            COVID            ‐19 pneumonia: An open‐label randomised trial
A1 Corral Gudino, Luis
A1 Cusácovich Torres, Iván
A1 Martín González, José Ignacio
A1 Muela Molinero, Alberto
A1 Abadía Otero, Jésica
A1 González Fuentes, Roberto
A1 Ruiz de Temiño de la Peña, Ángela
A1 Tapia Moral, Elena
A1 Cuadrado Medina, Francisca
A1 Martín Asenjo, Miguel
A1 Miramontes González, José Pablo
A1 Delgado González, José Luis
A1 Inés, Sandra
A1 Abad Manteca, Laura
A1 Usategui Martín, Iciar
A1 Ruiz Albi, Tomás
A1 Miranda Riaño, Sara
A1 Rodríguez Fortúnez, Patricia
A1 Rodríguez Jiménez, Consuelo
A1 López Franco, Esperanza
A1 Marcos, Miguel
K1 COVID- 19
K1 Dexamethasone
K1 Intubation
K1 Intratracheal
K1 Methylprednisolone
K1 Mortality
K1 32 Ciencias Médicas
AB Background: The efficacy and safety of high versus medium doses of glucocorticoids for the treatment of patients with COVID-19 has shown mixed outcomes in controlled trials and observational studies. We aimed to evaluate the effectiveness of methylprednisolone 250 mg bolus versus dexamethasone 6 mg in patients with severe COVID-19.Methods: A randomised, open-label, controlled trial was conducted between February and August 2021 at four hospitals in Spain. The trial was suspended after the first interim analysis since the investigators considered that continuing the trial would be futile. Patients were randomly assigned in a 1:1 ratio to receive dexamethasone 6 mg once daily for up to 10 days or methylprednisolone 250 mg once daily for 3 days.Results: Of the 128 randomised patients, 125 were analysed (mean age 60 ± 17 years; 82 males [66%]). Mortality at 28 days was 4.8% in the 250 mg methylprednisolone group versus 4.8% in the 6 mg dexamethasone group (absolute risk difference, 0.1% [95% CI, −8.8 to 9.1%]; p = 0.98). None of the secondary outcomes (admission to the intensive care unit, non-invasive respiratory or high-flow oxygen support, additional immunosuppressive drugs, or length of stay), or prespecified sensitivity analyses were statistically significant. Hyperglycaemia was more frequent in the methylprednisolone group at 27.0 versus 8.1% (absolute risk difference, −18.9% [95% CI, −31.8 to - 5.6%]; p = 0.007).Conclusions: Among severe but not critical patients with COVID-19, 250 mg/d for 3 days of methylprednisolone compared with 6 mg/d for 10 days of dexamethasone did not result in a decrease in mortality or intubation.
PB Wiley
SN 0014-2972
YR 2022
FD 2022
LK https://uvadoc.uva.es/handle/10324/57785
UL https://uvadoc.uva.es/handle/10324/57785
LA eng
NO European Journal of Clinical Investigation, 2022, vol. 53, n. 1, e13881.
NO Producción Científica
DS UVaDOC
RD 22-dic-2024