1125. Effect of intravenous pulses of methylprednisolone 250 mg versus dexamethasone 6 mg in hospitalized adults with severe COVID-19 pneumonia: an open-label randomized trial. (15th December 2022)

• Record Type: Journal Article
• Authors: Gutierrez, Carlos Dueñas; Abadia-Otero, Jesica; Cusacovich, Ivan; Martín-González, Jose Ignacio; Muela-Molinero, Alberto; Corral-Gudino, Luis; González-Fuentes, Roberto; de Temiño, Ängela Ruíz; Moral, Elena Tapia; Cuadrado-Medina, Francisca; Martín-Asenjo, Miguel; Gonzalez, Pablo Miramontes; Delgado Morales, Jose Luis; Ines, Sandra; Abad-Manteca, Laura; Usategui-Martín, Iciar; Ruíz-Albí, Tomás; Miranda-Riaño, Sara; Rodríguez-Fortúnez, Patricia; Rodríguez-Jiménez, Consuelo; López-Franco, Esperanza; Marcos, Miguel
• Is Part Of: Open forum infectious diseases. Volume 9:(2022)Supplement 2
• Publication Date: 2022-12-15
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofac492.964
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Pulse glucocorticoid therapy is used in COVID-19 infection. We evaluated the effectiveness of methylprednisolone 250 mg/d for 3 days vs. dexamethasone 6 mg/d for 10 days in patients with severe but not critical COVID-19 pneumonia. Methods: A multicentre, randomized, open-label, controlled trial was conducted between February 2021 and August 2021 at 4 hospitals in Spain and included 128 hospitalized adults with confirmed COVID-19 pneumonia needing oxygen therapy but not critically ill. Patients were randomly assigned in a 1:1 ratio to receive dexamethasone 6 once daily for 10 days or methylprednisolone 250 mg once daily for 3 days. The primary outcome was 28-day mortality. Results: Of the 128 randomized patients, 125 were analysed (mean age 60 ± 17 years; 82 males [66%]). Mortality at 28 days was 4.8% in the 250 mg methylprednisolone group vs. 4.8 % in the 6 mg dexamethasone group (absolute risk difference, 0.1% [95% CI, -8.8 to 9.1%]; P =0.98). The post-hoc added composite outcome of mortality at 90 days or intubation was 15.9% in the 250 mg methylprednisolone group vs. 15% in the 6 mg dexamethasone group (absolute risk difference, -0.9% [95% CI, -13.8 to 12.3%]; P =0.83). Hyperglycaemia was more frequent in the methylprednisolone group, at 27.0 vs. 8.1 % (absolute risk difference, -18.9% [95% CI, -31.8 to - 5.6%]; P =0.007). Conclusion: Among severe but not critical patients with COVID-19, 250 mg/d for 3 days of methylprednisolone compared with 6 mg/d for 10 days of dexamethasone did not result in a decrease in mortality or intubation. Disclosures: Carlos Dueñas Gutierrez, MD, ViIV, GILEAD, Jannsen, MSD: Lecture fees.