Evidence map›Paper›PMID 40803720›Full record

ArticleBMJ open2025

Role of Adjunctive corticoSTEROIDs on clinical outcomes in severe Scrub typhus pneumonitis: ASTEROIDS study protocol - a randomised controlled trial.

John Victor Peter, Balasubramanian Venkatesh, Prasanna S Premkumar, Binila Chacko, Karthik Gunasekaran, Bhuvana Krishna, Dhruva Chaudhry, Kavitha Saravu, Mukta Wyawahare, Sumit Ray and 4 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Article
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

14 authors.

John Victor PeterDepartment of Critical Care, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Balasubramanian VenkateshThe George Institute for Global Health, Sydney, New South Wales, Australia.
Prasanna S PremkumarDepartment of Biostatistics, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Binila ChackoDepartment of Critical Care, Christian Medical College Vellore, Vellore, Tamil Nadu, India.ORCID http://orcid.org/0000-0002-1609-2208
Karthik GunasekaranDepartment of General Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India karthikgunasekaran@yahoo.com.ORCID http://orcid.org/0000-0002-8615-5753
Bhuvana KrishnaDepartment of Critical Care Medicine, St John's Medical College Hospital, Bengaluru, India.
Dhruva ChaudhryPulmonary and Critical Care Medicine, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India.ORCID http://orcid.org/0000-0001-5138-2908
Kavitha SaravuDepartment of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Mukta WyawahareDepartment of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Sumit RayDepartment of Critical Care Medicine, Holy Family Hospital, New Delhi, India.
Vignesh Kumar ChandiraseharanDepartment of General Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.ORCID http://orcid.org/0000-0001-9117-1996
Ronald CareyDepartment of General Medicine, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Jasper RathinamDepartment of Critical Care, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
George M VargheseDepartment of Infectious Diseases, Christian Medical College Vellore, Vellore, Tamil Nadu, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRecent studies have demonstrated a beneficial role of steroids in severe community-acquired pneumonia, severe COVID-19 infection and acute respiratory distress syndrome (ARDS) of diverse aetiology. This multicentre randomised controlled trial in severe scrub typhus pneumonitis and ARDS will compare the effects of 6 mg of dexamethasone once per day with placebo, in addition to standard treatment, on ventilator-free days (VFD), mortality and ventilatory requirement. METHODS AND ANALYSIS: The study, involving six sites, will recruit 440 patients with severe scrub typhus pneumonitis or ARDS to concealed, block-randomised, site-specific assignment of dexamethasone or placebo for 4-7 days. The primary outcome will be VFD, defined as days alive and free of ventilation at 28 days. Secondary outcomes will include 28-day mortality, need and duration of ventilation, and treatment failure, defined as death, or escalation of respiratory support from simple devices (nasal cannula, mask) to non-invasive or invasive ventilation, or the use of open-labelled steroids for worsening shock. The study will also ascertain if antinuclear antibody (ANA) expression during the acute phase of illness will predict steroid responsiveness. Subgroup analyses will be conducted a priori on ANA expression and the need for ventilation. All analyses will be conducted on an intention-to-treat basis. The trial, which commenced in April 2025, would clarify the role of corticosteroids in scrub typhus pneumonitis. ETHICS AND DISSEMINATION: The Institutional Review Board and Ethics Committee of the lead site, Christian Medical College, Vellore, India, has approved the study (IRB Min No 15920 (INTERVE) dated 22 November 2023). The remaining five sites have obtained approval from their respective ethics committees. Study results will be published in an international peer-reviewed journal. TRIAL REGISTRATION NUMBER: CTRI/2024/12/077709. Registered 5 December 2024.

Indexed as

DexamethasoneGlucocorticoidsPneumoniaRespiratory Distress SyndromeScrub TyphusHumansMulticenter Studies as TopicRandomized Controlled Trials as TopicRespiration, ArtificialTreatment OutcomeDexamethasoneGlucocorticoidsAdult intensive & critical careClinical TrialDrug TherapyMortalityTropical medicineVentilators, Mechanical

Identifiers

PMID40803720
PMCPMC12352258

What OpenQuestion holds

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LicenceCC BY-NC
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.