Evidence map›Paper›PMID 32513294›Full record

ArticleTrials2020

Prednisolone versus placebo addition in the treatment of patients with recent-onset psychotic disorder: a trial design.

Lyliana G Nasib, Iris E Sommer, Inge Winter-van Rossum, Jacqueline de Vries, Shiral S Gangadin, Priscilla P Oomen, Gurmeet Judge, Renske E Blom, Jurjen J Luykx, Nico J M van Beveren and 3 more

2 registry-linked trialsOpen access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 52% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

NCT02949232 phase4terminatednot on this map

Prednisolone Addition for Patients With Recent-onset Psychotic Disorder: the Role of Immune-modulating Strategies in the Treatment of Psychosis

TypeinterventionalSponsorUMC UtrechtRan2014 to 2019Enrolled42ConditionsSchizophrenia, Schizoaffective Disorder, Schizophreniform Disorder, Psychotic Disorder NOSArmsPrednisolone, Placebo Oral Tablet
NCT03340909 phase2terminatednot on this map

The Norwegian Prednisolone in Early Psychosis Study - NorPEPS. The Role of Immune-modulating Strategies in the Treatment of Psychosis

TypeinterventionalSponsorHaukeland University HospitalRan2018 to 2021Enrolled12ConditionsSchizophrenia and Related Disorders, Immune Suppression, Psychosis, Cognitive ChangeArmsPrednisolone, Placebo
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Cytokine Imbalance as a Biomarker of Treatment-Resistant Schizophrenia.International journal of molecular sciences · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 3 countries.

Lyliana G NasibDepartment of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. Lnasib@umcutrecht.nl.ORCID http://orcid.org/0000-0003-3440-0777
Iris E SommerCognitive Neurosciences, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, The Netherlands.
Inge Winter-van RossumDepartment of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Jacqueline de VriesReinier van Arkel, 's-Hertogenbosch, The Netherlands.
Shiral S GangadinDepartment of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Priscilla P OomenDepartment of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Gurmeet JudgeGGZ Delfland, Delft, The Netherlands.
Renske E BlomDepartment of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Jurjen J LuykxDepartment of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Nico J M van BeverenAntes Center for Mental Health Care, Rotterdam, The Netherlands.
Natalie D VeenGGZ Delfland, Delft, The Netherlands.
Rune A KrokenNorment, Division of Psychiatry, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway.
Erik L JohnsenNorment, Division of Psychiatry, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway.
Utrecht University · NLUniversity Medical Center Groningen · NLGGZ Delfland · NLHaukeland University Hospital · NOErasmus MC · NLReinier van Arkel · NL

Funding

Stanley Medical Research Institute 12T-009Western Norway Regional Health Authority 912163
6 · The paper itself

Abstract

backgroundThe symptom severity of a substantial group of schizophrenia patients (30-40%) does not improve through pharmacotherapy with antipsychotic medication, indicating a clear need for new treatment options to improve schizophrenia outcome. Meta-analyses, genetic studies, randomized controlled trials, and post-mortem studies suggest that immune dysregulation plays a role in the pathophysiology of schizophrenia. Some anti-inflammatory drugs have shown beneficial effects on the symptom severity of schizophrenia patients. Corticosteroids are effective in various chronic inflammatory and autoimmune disorders. Prednisolone, a potent glucocorticosteroid, has minor mineral-corticosteroid potencies and can adequately pass the blood-brain barrier and its side effects and safety profile are well known. Therefore, the effect of prednisolone can be studied as a proof of concept for immune modulation as a treatment for schizophrenia. METHODS/

designIn total, 90 subjects aged 18-70 years and diagnosed with schizophrenia, schizoaffective disorder, or schizophreniform disorder (Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) 295.x) or psychosis not otherwise specified (NOS; 298.9) will be included. The time interval between the onset of psychosis and study entry should not exceed 7 years. Patients will be randomized 1:1 to either prednisolone or placebo daily for a period of 6 weeks in addition to a stable dose of antipsychotic medication. Study medication will be initiated at 40 mg for 3 days, after which it will be tapered down within 6 weeks after initiation, following inflammatory bowel diseases treatment guidelines. Primary outcome is change in symptom severity, expressed as change in total score on the Positive and Negative Symptom Scale (PANSS) from baseline to end of treatment. Cognitive functioning (measured through the Brief Assessment of Cognition in Schizophrenia (BACS)) and change in Global Assessment Functioning (GAF) and depressive symptoms as measured with the Calgary Depression Scale for Schizophrenia (CDS) will be assessed, in addition to various immunological biomarkers. Secondary outcomes are a 4- and 6-month follow-up assessment of PANSS, BACS, and GAF scores and immunological biomarkers. Additionally, a subgroup of patients will be included in the magnetic resonance imaging (MRI) part of the study where MR spectroscopy and structural, functional, and diffusion MRI will be conducted. DISCUSSION: It is expected that prednisolone addition to current antipsychotic medication use will reduce symptom severity and will improve cognition when compared to placebo.

trial registrationClinicalTrials.gov, NCT02949232 and NCT03340909. Registered 31 October 2016 and 14 November 2017. EudraCT-number 2014-000520-14 and 2017-000163-32.

Indexed as

Antipsychotic AgentsClinical Trials, Phase IV as TopicDrug Therapy, CombinationHumansMulticenter Studies as TopicPrednisolonePsychiatric Status Rating ScalesPsychotic DisordersRandomized Controlled Trials as TopicSchizophreniaTreatment OutcomeAntipsychotic AgentsPrednisoloneMRINeuro-inflammationPrednisolonePsychotic disordersTreatment

Identifiers

PMID32513294
PMCPMC7278136
OpenAlexW3033945637

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.