Evidence map›Paper›PMID 35723686›Full record

Trial reportIntensive care medicine2022

Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia.

G Umberto Meduri, Mei-Chiung Shih, Lisa Bridges, Thomas J Martin, Ali El-Solh, Nitin Seam, Anne Davis-Karim, Reba Umberger, Antonio Anzueto, Peruvemba Sriram and 13 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Intensive care medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
110citing papers in PubMed, 14 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

110 citing papers in PubMed, 14 syntheses or guidelines pooled it.

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  4. Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2025
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50 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

G Umberto MeduriPulmonary, Critical Care and Sleep Medicine Services, Memphis VA Medical Center, Memphis, USA. gmeduri@uthsc.edu.ORCID http://orcid.org/0000-0002-4848-8928
Mei-Chiung ShihVA Cooperative Studies Program Coordinating Center, Palo Alto, USA.
Lisa BridgesPulmonary, Critical Care and Sleep Medicine Services, Memphis VA Medical Center, Memphis, USA.
Thomas J MartinSalem VA Health Care System, Salem, USA.
Ali El-SolhVA Western New York Health Care System, Buffalo, USA.
Nitin SeamNational Institutes of Health Clinical Center, Bethesda, USA.
Anne Davis-KarimVA Cooperative Studies Program Pharmacy Coordinating Center, Albuquerque, USA.
Reba UmbergerUniversity of Tennessee Health Science Center, Memphis, USA.
Antonio AnzuetoSouth Texas Veterans Health San Antonio, San Antonio, USA.
Peruvemba SriramMalcom Randall VA Medical Center, Gainesville, USA.
Charlie LanMichael E Debakey VA Medical Center, Houston, USA.
Marcos I RestrepoSouth Texas Veterans Health San Antonio, San Antonio, USA.
Juan J GuardiolaRobley Rex VA Medical Center, Louisville, USA.
Teresa BuckBay Pines VA Healthcare Center, Bay Pines, USA.
David P JohnsonBay Pines VA Healthcare Center, Bay Pines, USA.
Anthony SuffrediniNational Institutes of Health Clinical Center, Bethesda, USA.
W Andrew BellRenown Health, Reno, NV, USA.
Julia LinVA Cooperative Studies Program Coordinating Center, Palo Alto, USA.
Lan ZhaoVA Cooperative Studies Program Coordinating Center, Palo Alto, USA.
Lauren UyedaVA Cooperative Studies Program Coordinating Center, Palo Alto, USA.
Lori NielsenVA Cooperative Studies Program Coordinating Center, Palo Alto, USA.
Grant D HuangOffice of Research and Development, Department of Veterans Affairs, Baltimore, USA.
ESCAPe Study Group

Funding

U.S. Department of Veterans Affairs, Cooperative Studies Program CSP #2009
6 · The paper itself

Abstract

purposeSevere community-acquired pneumonia (CAP) requiring intensive care unit admission is associated with significant acute and long-term morbidity and mortality. We hypothesized that downregulation of systemic and pulmonary inflammation with prolonged low-dose methylprednisolone treatment would accelerate pneumonia resolution and improve clinical outcomes.

methodsThis double-blind, randomized, placebo-controlled clinical trial recruited adult patients within 72-96 h of hospital presentation. Patients were randomized in 1:1 ratio; an intravenous 40 mg loading bolus was followed by 40 mg/day through day 7 and progressive tapering during the 20-day treatment course. Randomization was stratified by site and need for mechanical ventilation (MV) at the time of randomization. Outcomes included a primary endpoint of 60-day all-cause mortality and secondary endpoints of morbidity and mortality up to 1 year of follow-up.

resultsBetween January 2012 and April 2016, 586 patients from 42 Veterans Affairs Medical Centers were randomized, short of the 1420 target sample size because of low recruitment. 584 patients were included in the analysis. There was no significant difference in 60-day mortality between the methylprednisolone and placebo arms (16% vs. 18%; adjusted odds ratio 0.90, 95% CI 0.57-1.40). There were no significant differences in secondary outcomes or complications.

conclusionsIn patients with severe CAP, prolonged low-dose methylprednisolone treatment did not significantly reduce 60-day mortality. Treatment was not associated with increased complications.

Indexed as

Community-Acquired InfectionsPneumoniaAdultCritical IllnessHumansMethylprednisoloneRespiration, ArtificialTreatment OutcomeMethylprednisoloneCommunity-acquired pneumoniaGlucocorticoidsIntensive careMethylprednisoloneRandomized clinical trial

Identifiers

PMID35723686
PMCPMC9208259

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.