Evidence map›Paper›PMID 38082273›Full record

Trial reportBMC pulmonary medicine2023

Adjunct prednisone in community-acquired pneumonia: 180-day outcome of a multicentre, double-blind, randomized, placebo-controlled trial.

Claudine A Blum, Eva A Roethlisberger, Nicole Cesana-Nigro, Bettina Winzeler, Nicolas Rodondi, Manuel R Blum, Matthias Briel, Beat Mueller, Mirjam Christ-Crain, Philipp Schuetz

Registry-linked trialOpen access · goldAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC pulmonary medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00973154 (Corticosteroid Treatment for Community-Acquired Pneumonia A Randomized, Double-blind Study- The STEP Trial), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 16% 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.

NCT00973154 phase3completednot on this map

Corticosteroid Treatment for Community-Acquired Pneumonia A Randomized, Double-blind Study- The STEP Trial

TypeinterventionalSponsorUniversity Hospital, Basel, SwitzerlandRan2009 to 2014Enrolled800ConditionsCommunity-acquired PneumoniaArmsPrednisone
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Corticosteroids for treating sepsis in children and adults.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Review
  3. Review
  4. Safety of steroids in severe community-acquired pneumonia.European respiratory review : an official journal of the European Respiratory Society · 2025
    Review
  5. 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

10 authors at 4 institutions in 2 countries.

Claudine A Blum *Endocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, 4031, Basel, Switzerland. claudine.blum@unibas.ch.
Eva A Roethlisberger *Medical University Clinic, Division of General Internal & Emergency Medicine and Division of Endocrinology, Diabetology and Metabolism, Kantonsspital Aarau, 5001, Aarau, Switzerland.
Nicole Cesana-NigroEndocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, 4031, Basel, Switzerland.
Bettina WinzelerEndocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, 4031, Basel, Switzerland.
Nicolas RodondiInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Manuel R BlumInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Matthias BrielCLEAR-Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel and University of Basel, 4031, Basel, Switzerland.
Beat MuellerMedical University Clinic, Division of General Internal & Emergency Medicine and Division of Endocrinology, Diabetology and Metabolism, Kantonsspital Aarau, 5001, Aarau, Switzerland.
Mirjam Christ-Crain *Endocrinology, Diabetology and Metabolism, Department of Internal Medicine and Department of Clinical Research, University Hospital Basel, 4031, Basel, Switzerland.
Philipp Schuetz *Medical University Clinic, Division of General Internal & Emergency Medicine and Division of Endocrinology, Diabetology and Metabolism, Kantonsspital Aarau, 5001, Aarau, Switzerland.
Kantonsspital Aarau · CHUniversity Hospital of Basel · CHUniversity Hospital of Bern · CHImpact · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSeveral trials and meta-analyses found a benefit of adjunct corticosteroids for community-acquired pneumonia with respect to short-term outcome, but there is uncertainty about longer-term health effects. Herein, we evaluated clinical outcomes at long term in patients participating in the STEP trial (Corticosteroid Treatment for Community-Acquired Pneumonia).

methodsThis predefined secondary analysis investigated 180-day outcomes in 785 adult patients hospitalized with community-acquired pneumonia included in STEP, a randomised, placebo-controlled, double-blind trial. The primary endpoint was time to death from any cause at 180 days verified by telephone interview. Additional secondary endpoints included pneumonia-related death, readmission, recurrent pneumonia, secondary infections, new hypertension, and new insulin dependence.

resultsFrom the originally included 785 patients, 727 were available for intention-to-treat analysis at day 180. There was no difference between groups with respect to time to death from any cause (HR for corticosteroid use 1.15, 95% CI 0.68 to 1.95, p = 0.601). Compared to placebo, corticosteroid-treated patients had significantly higher risks for recurrent pneumonia (OR 2.57, 95% CI 1.29 to 5.12, p = 0.007), secondary infections (OR 1.94, 95% CI 1.25 to 3.03, p = 0.003) and new insulin dependence (OR 8.73, 95% CI 1.10 to 69.62, p = 0.041). There was no difference regarding pneumonia-related death, readmission and new hypertension.

conclusionsIn patients with community-acquired pneumonia, corticosteroid use was associated with an increased risk for recurrent pneumonia, secondary infections and new insulin dependence at 180 days. Currently, it is uncertain whether these long-term adverse effects outweigh the short-term effects of corticosteroids in moderate CAP.

trial registrationThis trial was registered with ClinicalTrials. gov, number NCT00973154 before the recruitment of the first patient. First posted: September 9, 2009. Last update posted: April 21, 2015.

Indexed as

CoinfectionCommunity-Acquired InfectionsHypertensionInsulinsPneumoniaAdrenal Cortex HormonesAdultDouble-Blind MethodHumansPrednisoneTreatment OutcomeAdrenal Cortex HormonesInsulinsPrednisoneCommunity-acquired pneumoniaCorticosteroidsGlucocorticoidsLower respiratory tract infectionsPrednisone

Identifiers

PMID38082273
PMCPMC10712075
OpenAlexW4389560705

What OpenQuestion holds

Textmetadata
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.