Syed Shahzad Hasan1, Chia Siang Kow2, Zia Ul Mustafa3, Hamid A Merchant1. 1. Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK. 2. School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia. 3. Department of Pharmacy, District Headquarters Hospital, Pakpattan, Pakistan.
Abstract
OBJECTIVES: The questions remained if mortality benefits with dexamethasone seen in patients with coronavirus disease 2019 (COVID-19) also extend to other systemic corticosteroids such as methylprednisolone. This article presents a meta-analysis of randomized controlled trials (RCTs) to ascertain if methylprednisolone can be recommended for use in patients with COVID-19 to prevent deaths. METHODS: Systematic literature search was performed in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and preprint servers until 13th April 2021. The outcome of interest was all-cause mortality. The random-effects model for the meta-analysis was utilized to estimate the pooled odds ratio (OR) at 95% confidence intervals (CI). RESULTS: Five RCTs were included in the meta-analysis. The pooled OR for all-cause mortality was 0.64 (95% CI: 0.29 -1.43, n=652) comparing methylprednisolone with the control, indicating no mortality benefits. A similar finding was noted with a sub-group analysis including four trials that used low-dose methylprednisolone. However, the only trial that administered high doses of methylprednisolone indicated a statistically significant mortality benefit (OR 0.08, 95% CI: 0.02-0.42). CONCLUSIONS: A short duration (3 to 5 days) pulse therapy of high-dose methylprednisolone can be a promising alternative to the low-dose dexamethasone therapy in severely ill patients with COVID-19 to prevent deaths.
OBJECTIVES: The questions remained if mortality benefits with dexamethasone seen in patients with coronavirus disease 2019 (COVID-19) also extend to other systemic corticosteroids such as methylprednisolone. This article presents a meta-analysis of randomized controlled trials (RCTs) to ascertain if methylprednisolone can be recommended for use in patients with COVID-19 to prevent deaths. METHODS: Systematic literature search was performed in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and preprint servers until 13th April 2021. The outcome of interest was all-cause mortality. The random-effects model for the meta-analysis was utilized to estimate the pooled odds ratio (OR) at 95% confidence intervals (CI). RESULTS: Five RCTs were included in the meta-analysis. The pooled OR for all-cause mortality was 0.64 (95% CI: 0.29 -1.43, n=652) comparing methylprednisolone with the control, indicating no mortality benefits. A similar finding was noted with a sub-group analysis including four trials that used low-dose methylprednisolone. However, the only trial that administered high doses of methylprednisolone indicated a statistically significant mortality benefit (OR 0.08, 95% CI: 0.02-0.42). CONCLUSIONS: A short duration (3 to 5 days) pulse therapy of high-dose methylprednisolone can be a promising alternative to the low-dose dexamethasone therapy in severely ill patients with COVID-19 to prevent deaths.
Authors: Elisabetta Caiazzo; Asma O M Rezig; Dario Bruzzese; Armando Ialenti; Carla Cicala; John G F Cleland; Tomasz J Guzik; Pasquale Maffia; Pierpaolo Pellicori Journal: Pharmacol Res Date: 2021-12-31 Impact factor: 7.658
Authors: Weibo Wan; Jingjing Zhou; Rong Lu; Chaoyang Wang; Shuli Hu; Mei Liu; Rong Xiong; Jing Kuang; Xuepeng Fan Journal: Evid Based Complement Alternat Med Date: 2022-07-06 Impact factor: 2.650