Impact of different corticosteroids on severe community-acquired pneumonia : a systematic review and meta-analysis
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVES: Randomised controlled trials (RCTs) have demonstrated conflicting results regarding the effects of corticosteroids on the treatment of severe community-acquired pneumonia (CAP). We aimed to investigate the efficacy and safety of different corticosteroids on patients who were hospitalised for severe CAP.
METHODS: We performed a systematic search through PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus from inception to May 2023. The primary outcome was all-cause mortality. Data analysis was performed using a random-effects model.
RESULTS: A total of 10 RCTs comprising 1962 patients were included. Corticosteroids were associated with a lower rate of all-cause mortality (risk ratio (RR), 0.70 (95% CI 0.54 to 0.90); I2=0.00%). When stratified into different corticosteroid types, hydrocortisone was associated with an approximately 50% lower mortality risk (RR, 0.48 (95% CI 0.32 to 0.72); I2=0.00%). However, dexamethasone, methylprednisolone or prednisolone were not associated with an improvement in mortality. Furthermore, hydrocortisone was associated with a reduction in the rate of mechanical ventilation, acute respiratory distress syndrome, shock and duration of intensive care unit stay. These trends were not observed for dexamethasone, methylprednisolone or prednisolone. Corticosteroids were not associated with an increased risk of adverse events including gastrointestinal bleeding, secondary infection or hyperglycaemia.
CONCLUSIONS: The use of hydrocortisone, but not other types of corticosteroids, was associated with a reduction in mortality and improvement in pneumonia outcomes among patients hospitalised with severe CAP.PROSPERO registration numberCRD42023431360.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2024 |
---|---|
Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
---|---|
Enthalten in: |
BMJ open respiratory research - 11(2024), 1 vom: 22. Jan. |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
See, Xin Ya [VerfasserIn] |
---|
Links: |
---|
Themen: |
7S5I7G3JQL |
---|
Anmerkungen: |
Date Completed 25.01.2024 Date Revised 04.03.2024 published: Electronic Citation Status MEDLINE |
---|
doi: |
10.1136/bmjresp-2023-002141 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM367530880 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | NLM367530880 | ||
003 | DE-627 | ||
005 | 20240304232326.0 | ||
007 | cr uuu---uuuuu | ||
008 | 240124s2024 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1136/bmjresp-2023-002141 |2 doi | |
028 | 5 | 2 | |a pubmed24n1316.xml |
035 | |a (DE-627)NLM367530880 | ||
035 | |a (NLM)38262670 | ||
035 | |a (PII)e002141 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a See, Xin Ya |e verfasserin |4 aut | |
245 | 1 | 0 | |a Impact of different corticosteroids on severe community-acquired pneumonia |b a systematic review and meta-analysis |
264 | 1 | |c 2024 | |
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 25.01.2024 | ||
500 | |a Date Revised 04.03.2024 | ||
500 | |a published: Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
520 | |a OBJECTIVES: Randomised controlled trials (RCTs) have demonstrated conflicting results regarding the effects of corticosteroids on the treatment of severe community-acquired pneumonia (CAP). We aimed to investigate the efficacy and safety of different corticosteroids on patients who were hospitalised for severe CAP | ||
520 | |a METHODS: We performed a systematic search through PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus from inception to May 2023. The primary outcome was all-cause mortality. Data analysis was performed using a random-effects model | ||
520 | |a RESULTS: A total of 10 RCTs comprising 1962 patients were included. Corticosteroids were associated with a lower rate of all-cause mortality (risk ratio (RR), 0.70 (95% CI 0.54 to 0.90); I2=0.00%). When stratified into different corticosteroid types, hydrocortisone was associated with an approximately 50% lower mortality risk (RR, 0.48 (95% CI 0.32 to 0.72); I2=0.00%). However, dexamethasone, methylprednisolone or prednisolone were not associated with an improvement in mortality. Furthermore, hydrocortisone was associated with a reduction in the rate of mechanical ventilation, acute respiratory distress syndrome, shock and duration of intensive care unit stay. These trends were not observed for dexamethasone, methylprednisolone or prednisolone. Corticosteroids were not associated with an increased risk of adverse events including gastrointestinal bleeding, secondary infection or hyperglycaemia | ||
520 | |a CONCLUSIONS: The use of hydrocortisone, but not other types of corticosteroids, was associated with a reduction in mortality and improvement in pneumonia outcomes among patients hospitalised with severe CAP.PROSPERO registration numberCRD42023431360 | ||
650 | 4 | |a Meta-Analysis | |
650 | 4 | |a Systematic Review | |
650 | 4 | |a Journal Article | |
650 | 4 | |a Critical Care | |
650 | 4 | |a Pneumonia | |
650 | 4 | |a Respiratory Infection | |
650 | 7 | |a Hydrocortisone |2 NLM | |
650 | 7 | |a WI4X0X7BPJ |2 NLM | |
650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
650 | 7 | |a Methylprednisolone |2 NLM | |
650 | 7 | |a X4W7ZR7023 |2 NLM | |
650 | 7 | |a Dexamethasone |2 NLM | |
650 | 7 | |a 7S5I7G3JQL |2 NLM | |
700 | 1 | |a Wang, Tsu Hsien |e verfasserin |4 aut | |
700 | 1 | |a Chang, Yu-Cheng |e verfasserin |4 aut | |
700 | 1 | |a Lo, Juien |e verfasserin |4 aut | |
700 | 1 | |a Liu, Weitao |e verfasserin |4 aut | |
700 | 1 | |a Choo, Cheryn Yu Wei |e verfasserin |4 aut | |
700 | 1 | |a Lee, Yu-Che |e verfasserin |4 aut | |
700 | 1 | |a Ma, Kevin Sheng Kai |e verfasserin |4 aut | |
700 | 1 | |a Chiang, Cho-Hsien |e verfasserin |4 aut | |
700 | 1 | |a Hsia, Yuan Ping |e verfasserin |4 aut | |
700 | 1 | |a Chiang, Cho-Hung |e verfasserin |4 aut | |
700 | 1 | |a Chiang, Cho-Han |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t BMJ open respiratory research |d 2013 |g 11(2024), 1 vom: 22. Jan. |w (DE-627)NLM244313849 |x 2052-4439 |7 nnns |
773 | 1 | 8 | |g volume:11 |g year:2024 |g number:1 |g day:22 |g month:01 |
856 | 4 | 0 | |u http://dx.doi.org/10.1136/bmjresp-2023-002141 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 11 |j 2024 |e 1 |b 22 |c 01 |