ArticleOpen forum infectious diseases2014
Corticosteroid effects on sputum culture in pulmonary tuberculosis: a meta-regression analysis.
Article in Open forum infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effects of anti-inflammatory agents as host-directed adjunct treatment of tuberculosis in humans: a systematic review and meta-analysis.Respiratory research · 2020Pooled it
- Host-directed immunotherapy of viral and bacterial infections: past, present and future.Nature reviews. Immunology · 2023Review
- Host-Directed Therapies: Modulating Inflammation to Treat Tuberculosis.Frontiers in immunology · 2021Review
- Tuberculosis and lung damage: from epidemiology to pathophysiology.European respiratory review : an official journal of the European Respiratory Society · 2018Review
- The Immune Mechanisms of Lung Parenchymal Damage in Tuberculosis and the Role of Host-Directed Therapy.Frontiers in microbiology · 2018Review
- Host-directed therapies for bacterial and viral infections.Nature reviews. Drug discovery · 2018Review
- Pulmonary Tuberculosis Versus Recurrent Chemotherapy-Induced Pneumonitis: A Clinical Dilemma.Cureus · 2017Article
- Host-Directed Therapeutic Strategies for Tuberculosis.Frontiers in medicine · 2017Review
- The pregnane X receptor in tuberculosis therapeutics.Expert opinion on drug metabolism & toxicology · 2016Review
- Targeting Batf2 for infectious diseases and cancer.Oncotarget · 2015Article
- Advancing host-directed therapy for tuberculosis.Nature reviews. Immunology · 2015Review
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThere is increasing interest in the potential role of adjunctive anti-inflammatory therapy to accelerate tuberculosis (TB) treatment. Sputum culture conversion is an important biomarker predictor of durable TB cure.
methodsThis study used meta-regression analysis to examine the relationship between corticosteroid dose and sputum culture conversion, using published data from controlled clinical trials including 1806 corticosteroid-treated TB patients.
resultsLinear models with 2 or 3 variables, including corticosteroid dose and the proportion of culture positive control subjects, predicted therapeutic benefit of corticosteroids at 1 and 2 months. The 3-variable model predicted that 134 mg of prednisolone per day, given together with standard 4-drug TB chemotherapy, would reduce the proportion of positive culture at 2 months from 15% to 2%. The estimate accounts for a 50% reduction in steroid exposure due to rifampin. A proportion of 2% of subjects with positive cultures at 2 months has been proposed as a target for new 4-month TB regimens.
conclusionsThese positive findings must be tempered by recognition that the metabolic and cardiovascular risks of corticosteroids administered at this dose for this duration are unlikely to be acceptable when examined from a patient-level benefit-risk perspective. In future research studies to shorten TB treatment, biologic anti-inflammatory therapies with similar therapeutic effects but superior safety profiles should be considered.
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