Does methylprednisolone reduce the mortality risk in hospitalized COVID-19 patients? A meta-analysis of randomized control trials
Objectives: The question remained if mortality benefits with dexamethasone seen in patients with coronavirus disease 2019 (COVID-19) also extend to other systemic corticosteroids such as methylprednisolone. This article presents a meta-analysis of randomized controlled trials (RCTs) to ascertain if methylprednisolone can be recommended for use in patients with COVID-19 to prevent deaths.Methods: Systematic literature search was performed in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and preprint servers until 13 April 2021. The outcome of interest was all-cause mortality. The random-effects model for the meta-analysis was utilized to estimate the pooled odds ratio (OR) at 95% confidence intervals (CI).Results: Five RCTs were included in the meta-analysis. The pooled OR for all-cause mortality was 0.64 (95% CI: 0.29 - 1.43, n = 652) comparing methylprednisolone with the control, indicating no mortality benefits. A similar finding was noted with a sub-group analysis including four trials that used low-dose methylprednisolone. However, the only trial that administered high dose methylprednisolone indicated a statistically significant mortality benefit (OR 0.08, 95% CI: 0.02-0.42).Conclusions: In determining equipotent doses for an acute short-course pulse therapy of corticosteroids, the biological half-life of steroids should also be accounted for besides the potency factor. A short duration (3-5 days) pulse therapy of high-dose methylprednisolone can be a promising alternative to the low-dose dexamethasone therapy in severely ill patients with COVID-19 to prevent deaths.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
|---|---|
| Enthalten in: |
Expert review of respiratory medicine - 15(2021), 8 vom: 01. Aug., Seite 1049-1055 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Hasan, Syed Shahzad [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
7S5I7G3JQL |
|---|
| Anmerkungen: |
Date Completed 19.08.2021 Date Revised 19.08.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1080/17476348.2021.1925546 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM324983565 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM324983565 | ||
| 003 | DE-627 | ||
| 005 | 20231225191453.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1080/17476348.2021.1925546 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1083.xml |
| 035 | |a (DE-627)NLM324983565 | ||
| 035 | |a (NLM)33945381 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Hasan, Syed Shahzad |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Does methylprednisolone reduce the mortality risk in hospitalized COVID-19 patients? A meta-analysis of randomized control trials |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 19.08.2021 | ||
| 500 | |a Date Revised 19.08.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Objectives: The question remained if mortality benefits with dexamethasone seen in patients with coronavirus disease 2019 (COVID-19) also extend to other systemic corticosteroids such as methylprednisolone. This article presents a meta-analysis of randomized controlled trials (RCTs) to ascertain if methylprednisolone can be recommended for use in patients with COVID-19 to prevent deaths.Methods: Systematic literature search was performed in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and preprint servers until 13 April 2021. The outcome of interest was all-cause mortality. The random-effects model for the meta-analysis was utilized to estimate the pooled odds ratio (OR) at 95% confidence intervals (CI).Results: Five RCTs were included in the meta-analysis. The pooled OR for all-cause mortality was 0.64 (95% CI: 0.29 - 1.43, n = 652) comparing methylprednisolone with the control, indicating no mortality benefits. A similar finding was noted with a sub-group analysis including four trials that used low-dose methylprednisolone. However, the only trial that administered high dose methylprednisolone indicated a statistically significant mortality benefit (OR 0.08, 95% CI: 0.02-0.42).Conclusions: In determining equipotent doses for an acute short-course pulse therapy of corticosteroids, the biological half-life of steroids should also be accounted for besides the potency factor. A short duration (3-5 days) pulse therapy of high-dose methylprednisolone can be a promising alternative to the low-dose dexamethasone therapy in severely ill patients with COVID-19 to prevent deaths | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Coronavirus | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a corticosteroids | |
| 650 | 4 | |a deaths | |
| 650 | 4 | |a dexamethasone | |
| 650 | 4 | |a methylprednisolone | |
| 650 | 4 | |a pandemic | |
| 650 | 7 | |a Glucocorticoids |2 NLM | |
| 650 | 7 | |a Dexamethasone |2 NLM | |
| 650 | 7 | |a 7S5I7G3JQL |2 NLM | |
| 650 | 7 | |a Methylprednisolone |2 NLM | |
| 650 | 7 | |a X4W7ZR7023 |2 NLM | |
| 700 | 1 | |a Kow, Chia Siang |e verfasserin |4 aut | |
| 700 | 1 | |a Mustafa, Zia Ul |e verfasserin |4 aut | |
| 700 | 1 | |a Merchant, Hamid A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Expert review of respiratory medicine |d 2007 |g 15(2021), 8 vom: 01. Aug., Seite 1049-1055 |w (DE-627)NLM190765666 |x 1747-6356 |7 nnns |
| 773 | 1 | 8 | |g volume:15 |g year:2021 |g number:8 |g day:01 |g month:08 |g pages:1049-1055 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1080/17476348.2021.1925546 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 15 |j 2021 |e 8 |b 01 |c 08 |h 1049-1055 | ||